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Tell us about your Loved One: (If you have experienced multiple military losses, please list most recent first. Your account can hold information for up to three Loved Ones.)

Loved One Was MY

Loved One's Rank/Title

Loved One's First Name

Loved One's Last Name

Loved One's Branch Of Service

Loved One's Duty Status

Loved One's Military Conflicts

	1. World War I (Apr 1917 - Nov 1918)
	2. World War II (Dec 1941 - Dec 1946)
	3. Korean War (Jun 1950 - Jan 1955)
	4. Vietnam War (Nov 1955 - May 1975)
	5. Gulf War (Aug 1990 - TBD)
	6. OEF: Afghanistan (Oct 2001 - Dec 2014)
	7. OIF: Iraq (Mar 2003 - Nov 2011)

Loved One's Last Station

Loved One's Cause Of Death

Loved One's Date Of Death

Signature Certification:

I understand that this restricted site is intended for the private use of and safe exchange of information among adult (18 years of age and older): survivors who have been affected by the death of a person whose life included military service as well as volunteers and supporters of TAPS.

By accepting the terms of the agreement and typing full name in the electronic signature below, I verify that the personal information I provide to TAPS is accurate and agree to abide by any and all restrictions set forth on this site, including, but not limited to the "Terms" of use. Furthermore, I agree that I will not use the TAPS Portal and Online Community to attempt interviews with group members for research or other purposes. I will maintain all conversations in a supportive, respectful, and compassionate manner, and will refrain from engaging in divisive topics (i.e., politics, religion).

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