This form is to honor the First Responders and Veterans who are casualties of September 11,2001, and the following wars in Iraq and Afghanistan. With the information provided, Hero Services will stamp a Dog Tag/ Accountability Tag for the deceased Veteran or First Responder who have made the ultimate sacrifice during combat or during the attacks on September 11(including illnesses that were a result of Ground Zero) . Their name will be forever memorialized as a part of our “Towers of the Fallen” monument. This monument is on display as a part of the September 11 Memorial Walkway, annually at our Strikes for Stripes event, which is held on the Saturday after September 11.

Our Initial intentions is to honor the lives lost in combat and of the response to ground zero during the attack. This monument will be developed over the next several months to year(s) until all of our Fallen Heroes are memorialized in this monument.

Note: All names provided will be verified through DOD and various First Responder publications

Name of Deceased

First Name

Last Name

Branch of Service and Rank

Casualty Date (Month and Year)

Location of passing

If possible please provide city and country (or state) of where the individual passed example: Baghdad, Iraq or New York, New York

Please annotate under what circumstances they have passed.

Killed In Action (KIA)

Line of Duty Death (LOD)

Other

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