Claim for loss of life #9 – Particulars

	No. of Claim	Name and description of Claimant	Whether Executor or Administrator of Deceased Person
	9	Alfred Green of 19 Grove Street, Pye Bank, Edge Tool Hardener	The Claimant is the only child & sole next of kin of the deceased who died intestate but no Administration has yet been taken out

Name and Description of Deceased Person	Party for whose benefit the claim is made, being Wife or Husband of the deceased person or his or her parent or child as defined in 9 and 10 Victoria C.93	Amount of Damages Claimed
Elizabeth Green, late of Harvest Lane, Widow	Alfred Green the only child of the deceased	£60
	Withdrawn