Now Creating Your ~PYR™~ Account!

1
Would you like to "Review Pricing Detail" prior to Checkout?Simply CLICK YES to review
YESNO
2
Just "Where In The World Are You?"* This field is required.Please "tick" your Country, State or Province and then City! -Thanks! This is a two-step (2) process along with the field to follow...
3
Please Provide Your Specific, Primary Address* This field is required.Both for Client Submission Verification and any Mailings Requested
Your "Street" Address
P.O. Box, Apartment or Suite Identifier; Street Address Line 2
City
State
Postal / Zip Code (9-digit if you have it handy)
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Take Your Photo [OPTIONAL]Please "take a simple Selfie"
5
Make a simple Voice Recording [OPTIONAL]Say, "Yes, I am a human being and I am alive today" or anything else you'd like!
6
Please type your FULL NAME* This field is required.If applicable, enter any "nickname"... a "maiden name" and/or previous "last name(s)"
Your First Name
Your FULL Middle Name, please~
Current Legal Last Name
7
...cont'd FULL NAME detail* This field is required.If applicable, enter any "nickname"... a "maiden name" and/or previous "last name(s)"
Any "NICKNAME"?
Your "Maiden Name" (if applicable)
Any previous "Surname" (Last Name)
8
Your Preferred and Confidential email* This field is required.Please use your "most used and a private email address"!
9
Your Phone Number* This field is required.Your smartphone or other "most used phone"!
Please enter a valid phone number.
10
2-Step Verification Fieldvia Twilio® Worldwide applications
11
Initials (Optional)First Name Letter then Last Name Letter is fine
12
Continue "Now" or "Soon"* This field is required.You may SAVE your work so far and you'll be emailed a link to "pick up where you left off"...
SAVE and Continue SoonCONTINUE Now
13
This is your Client Account Password!You may allow this pre-generated one to remain or manually change it. You may also change it later! PLEASE COPY THIS DOWN AND KEEP RECORDED IN A SAFE PLACE FOR FUTURE REFERENCE!
14
Here You'll Upload Your Heartfelt Video(s) and/or otherwise Very Important File(s)!* This field is required.The vast majority of our clients upload a "less than 10-minutes video file". You may upload up 30-minutes of video, audio or virtually any type of media with Picture-Yourself-Remembered™
15
Your Message is now being Digitally and Securely Archived within our Egnyte®Trusted by 22,000+ Content-Critical Businesses Worldwide
16
Name Your Primary Recipient to This Particular Message* This field is required.Please Complete All Fields in Full, including a FULL MIDDLE NAME or "None" if indeed none. -Thank You!
Your Primary Recipient's First Name
Middle Name
Your Primary Recipient's Last Name
17
...cont'd Primary Recipient's FULL NAME detail* This field is required.Please Complete All Fields in Full. -Thank You!
Primary Recipient's "Nickname" (if any)
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
18
How Are You Related to this Primary Recipient* This field is required....or otherwise acquainted
Spouse
Spouse
Child
Sibling (natural0
Sibling (step)
Grandchild or even Great Grand'
Immediate Family Member
Distant Family Member
Close Friend
Business Relationship
19
Enter Your Primary Recipient's Current Address* This field is required....to the very best of your ability, please!
List Your Primary Recipient's "Street Address"
List Your Primary Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
20
Enter Your Primary Recipient's Email Address* This field is required.Please make this "their most used email address"; you may add more later!
MyPrimaryRecipient@theiremail.com
21
Your Primary Recipient's Phone Number* This field is required.SmartPhone if used most often; Landline if not...
Please enter a valid phone number.
22
Your Preferred Delivery Method to This Particular Recipient* This field is required.Each message and each Recipient may be distinct Delivery Methods~ That's OK!
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
23
Need more space to tell us about this recipient?[OPTIONAL]
24
Do you want to add an additional recipient to this particular form?* This field is required.You currently have one (1) Primary Recipient to this particular message!
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
25
Name Your Second (2nd) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 2nd Recipient's First Name
Middle Name
This Recipient's Last Name
26
...cont'd Second (2nd) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 2nd Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
27
Enter Your Second (2nd) Recipient's Address...to the very best of your ability, please!
List Your 2nd Recipient's "Street Address"
List Your 2nd Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
28
Enter Your Second (2nd) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MySecondRecipient@theiremail.com
29
Your Second (2nd) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Please enter a valid phone number.
30
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your second recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
31
Need more space to tell us about this recipient?
32
Do you want to add a third (3rd) recipient to this particular form?You currently have two (2) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
33
Name Your Third (3rd) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 3rd Recipient's First Name
Middle Name
This Recipient's Last Name
34
...cont'd Third (3rd) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 3rd Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
35
Enter Your Third (3rd) Recipient's Address...to the very best of your ability, please!
List Your 3rd Recipient's "Street Address"
List Your 3rd Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
36
Enter Your Third (3rd) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MyThirdRecipient@theiremail.com
37
Your Third (3rd) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Please enter a valid phone number for this, your 3rd recipient
38
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your third recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
39
Need more space to tell us about this recipient?
40
Do you want to add a fourth (4th) recipient to this particular form?You currently have three (3) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
41
Name Your Fourth (4th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 4th Recipient's First Name
Middle Name
This Recipient's Last Name
42
...cont'd Fourth (4th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 4th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
43
Enter Your Fourth (4th) Recipient's Address...to the very best of your ability, please!
List Your 4th Recipient's "Street Address"
List Your 4th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
44
Enter Your Fourth (4th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MyFourthRecipient@theiremail.com
45
Your Fourth (4th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
46
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your fourth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
47
Need more space to tell us about this recipient?
48
Do you want to add a fifth (5th) recipient to this particular form?You currently have four (4)) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
49
Name Your Fifth (5th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 5th Recipient's First Name
Middle Name
This Recipient's Last Name
50
...cont'd Fifth (5th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 5th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
51
Enter Your Fifth (5th) Recipient's Address...to the very best of your ability, please!
List Your 5th Recipient's "Street Address"
List Your 5th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
52
Enter Your Fifth (5th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MyFifthRecipient@theiremail.com
53
Your Fifth (5th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
54
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your fifth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
55
Need more space to tell us about this recipient?
56
Do you want to add a sixth (6th) recipient to this particular form?You currently have five (5) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
57
Name Your Sixth (6th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 6th Recipient's First Name
Middle Name
This Recipient's Last Name
58
...cont'd Third (6th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 6th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
59
Enter Your Sixth (6th) Recipient's Address...to the very best of your ability, please!
List Your 6th Recipient's "Street Address"
List Your 6th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
60
Enter Your Sixth (6th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MySixthRecipient@theiremail.com
61
Your Sixth (6th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
62
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your fifth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
63
Need more space to tell us about this recipient?
64
Do you want to add a seventh (7th) recipient to this particular form?You currently have six (6) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
65
Name Your Seventh (7th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 7th Recipient's First Name
Middle Name
This Recipient's Last Name
66
...cont'd Third (7th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 7th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
67
Enter Your Seventh (7) Recipient's Address...to the very best of your ability, please!
List Your 7th Recipient's "Street Address"
List Your 7th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
68
Enter Your Seventh(7th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MySeventhRecipient@theiremail.com
69
Your Seventh (7th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
70
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your sixth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
71
Need more space to tell us about this recipient?
72
Do you want to add an eighth (8th) recipient to this particular form?You currently have seven (7) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
73
Name Your Eighth (8th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 8th Recipient's First Name
Middle Name
This Recipient's Last Name
74
...cont'd Eighth (8th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 8th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
75
Enter Your Eighth (8th) Recipient's Address...to the very best of your ability, please!
List Your 8th Recipient's "Street Address"
List Your 8th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
76
Enter Your Eighth (8th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MyEighthRecipient@theiremail.com
77
Your Eighth (8th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
78
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your sixth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
79
Need more space to tell us about this recipient?
80
Do you want to add a ninth (9th) recipient to this particular form?You currently have eight (8) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
81
Name Your Ninth (9th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 9th Recipient's First Name
Middle Name
This Recipient's Last Name
82
...cont'd Ninth (9th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 9th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
83
Enter Your Ninth (9th) Recipient's Address...to the very best of your ability, please!
List Your 9th Recipient's "Street Address"
List Your 9th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
84
Enter Your Ninth (9th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MyNinthRecipient@theiremail.com
85
Your Ninth (9th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
86
Need more space to tell us about this recipient?
87
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your sixth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
88
Do you want to add a tenth (10th) recipient to this particular form?You currently have ninr (9) recipients to this particular message!
PLEASE CHOOSE>
Yes, I do!
No, I don't
No, not at this time
Again, you may add up to ten (10) total recipients and you may add [them] later...
89
Name Your Tenth (10th) Recipient to This Particular MessagePlease Complete All Fields in Full. -Thank You!
Your 10th Recipient's First Name
Middle Name
This Recipient's Last Name
90
...cont'd Tenth (10th) Recipient's FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 10th Recipient's Middle Name
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
91
Enter Your Tenth (10) Recipient's Address...to the very best of your ability, please!
List Your 10th Recipient's "Street Address"
List Your 10th Recipient's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
92
Enter Your Tenth (10th) Recipient's Email AddressPlease make this "their most used email address"; you may add more later!
MyTenthRecipient@theiremail.com
93
Your Tenth (10th) Recipient's Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
94
Your Preferred Delivery Method to This Particular RecipientHow do you want this, your sixth recipient, to Receive Your "Digital Remembrance Vehicle"?
email (at least 2 common formats)
A USB file via USPS
UPS / FedEx or similar carrier
Other
95
Need more space to tell us about this recipient?
96
Continue "Now" or "Soon"* This field is required.You may SAVE your work so far and you'll be emailed a link to "pick up where you left off"...
SAVE and Continue SoonCONTINUE Now
97
"Tap the Dot" and Draw Over the Design!Begin at "the dot" and Trace with One, Firm Motion! (Optional) because this feature requires a "touch screen" or similar technology
98
This Field Allows You "Write" a Digital Remembrance Vehicle™ to Your Recipient(s) in Addition To or Instead of Video Format!Simply "tick within the field" and type your message or cut & paste from previous correspondence or news articles. You have a lot of flexibility with this field!
99
Your Message Is Being Created for Your Recipient(s)Message in a Bottle In Transit
100
How can we monitor your desires for your messages?* This field is required.Which Method of Contact Do You Prefer? You may choose [up to] two (2) methods!
contact you by email (us to you)
contact you by smartphone (us to you)
contact you by USPS or other government mail
contact you by SMS (text message) (us to you)
Other
101
Just How Often Would You Like Contacted?* This field is required.Our Contacting You Will Allow Us to both Monitor and Act upon your exacting desires!
Once per Month
Once per 90-days
Once per 6-months
Once per Year
Other
102
What does ~PYR~™ Do In The Case That You Don't Respond?* This field is required.Say... after three (3) days of our contact out reach attempts...
Wait two weeks - Vacation?
Immediately follow my Alternative
Immediately send my message!
Other
103
Just What "Triggers" This particular Message to be Sent to Recipient(s)You will have several options within the following screens! Or... type your thoughts here~
104
Your Client Account ID
You may change this at a later time! For now, PLEASE COPY THIS DOWN!
105
"Alternate Contact" if Needed* This field is required.You've already told us "if-and-when" to contact this person or entity!
First Name
Middle Name
Last Name
106
...cont'd "Alternate Contact" FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your Alternative Contact's "Nickname" (if any)
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
107
Enter Your Alternate Contact's Address* This field is required....to the very best of your ability, please!
List Your Primary Alternative Contact's "Street Address"
List Your Alternative Contact's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
108
Enter Your "Alternate Contact's" Email Address* This field is required.Please make this "their most used email address"; you may add more later!
MyFirstAltContact@theiremail.com
109
Your "Alternate Contact's" Phone Number* This field is required.SmartPhone if used most often; Landline if not...
Please enter a valid phone number.
110
Need more space to tell us about this Alternate Contact?
111
Do you want to add a Second "Alternate Contact" to this particular form?* This field is required.
112
"Your 2nd Alternative Contact"You've already told us "if-and-when" to contact this person or entity!
First Name [alt2]
Middle Name
Last Name [alt2]
113
...cont'd "Your 2nd Alternate Contact's" FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 2nd Alternative Contact's
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
114
Enter Your 2nd Alternate Contact's Address...to the very best of your ability, please!
List Your Second Alternative Contact's "Street Address"
List Your Alternative Contact's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
115
Enter Your 2nd "Alternate Contact's" Email AddressPlease make this "their most used email address"; you may add more later!
MySecondAltContact@theiremail.com
116
Your 2nd "Alternate Contact's" Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
117
Need more space to tell us about this Alternate Contact?
118
Do you want to add a Third "Alternate Contact" to this particular form?
119
"Your 3rd Alternate Contact"You've already told us "if-and-when" to contact this person or entity!
First Name [alt3]
Middle Name
Last Name [alt3]
120
...cont'd "Your 3rd Alternate Contact's" FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 3rd Alternative Contact's
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
121
Enter Your 3rd Alternate Contact's Address...to the very best of your ability, please!
List Your Third Alternative Contact's "Street Address"
List Your Alternative Contact's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
122
Enter Your 3rd "Alternate Contact's" Email AddressPlease make this "their most used email address"; you may add more later!
MyThirdAltContact@theiremail.com
123
Your 3rd "Alternate Contact's" Phone NumberSmartPhone if used most often; Landline if not...
Area Code
Phone Number
124
Do you want to add a FOURTH "Alternate Contact" to this particular form?
125
Need more space to tell us about this Alternate Contact?
126
"Your 4th Alternate Contact"You've already told us "if-and-when" to contact this person or entity!
First Name [alt3]
Middle Name
Last Name [alt3]
127
...cont'd "Your 4th Alternate Contact's" FULL NAME detailPlease Complete All Fields in Full. -Thank You!
Your 3rd Alternative Contact's
"Maiden" Name (if any)
Any other Surname(s), Previous Last Name(s)
128
Enter Your 4th Alternate Contact's Address...to the very best of your ability, please!
List Your Third Alternative Contact's "Street Address"
List Your Alternative Contact's "Street Address Line 2"
City
State
Zip Code (9-digit if known)
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
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Enter Your 5th "Alternate Contact's" Email AddressPlease make this "their most used email address"; you may add more later!
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One (1) or more Digital Remembrance Vehicle℠
This, a one-time cost of just $148.00*, provides you an archived, single (1) Digital Remembrance Vehicle™ securely stored within our server farms configuration. Stored as per your exacting instructions to us during your initial account setup. *$148.00 is a promotional price point; may be changed with or without notice at any time! The anticipated price point at some time in the future may be $198.00+-...
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State of Ohio "Rule 5703-9-46 | Sales and use taxes: automatic data processing, computer services, and electronic information services." ● https://codes.ohio.gov/ohio-administrative-code/rule-5703-9-46
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