*Are you a man or woman?
manwoman

*Where you born on the island of Ireland?
YesNo

*Phone number (Please put a space somewhere in the phone number)

*Your email

*Your First Name as it appears on your Birth certificate.

*Your Middle Name/Names as on Birth Certificate

*Your Current Family Name to be Re/Conveyed

*What is first line of your Street address?

*What Town do you live in?

*What County do you live in? (Do not write the word 'Co' or 'County')

*Postcode

Which part of Ireland do you live on?
Republic of IrelandNorthern Ireland

*What is your born date? (Written as 10th January 1901)

*What County were you born on? (Do not write the word 'Co' or 'County')

Only complete questions about off-spring under 21 years that you wish to reconvey with you.

*What Country were you born on?

*What county will your witness be on when you autograph your paperwork? (Do not write the word 'County')

*What country will your witness be on when you autograph paperwork?

*What is the tracking number of letter to self (Your recording number)

*Who will witness you autographing the paperwork?
Public Notary in personPublic Notary via remoteTerra Ériú Assembly Notarial Witness3 people you know

*How will you be making your donation?
CryptoMoneyMany Good deeds

Add any comments or clarification

*Attach a passport style photograph of yourself, plain background, no glasses (Size limit 6mb)