Death Certificate Application

Request your official Death Certificate by Mail from Home

Death information of the person on record

Please enter the information of the individual who needs the death certificate. If you are applying for someone else (i.e. your child), enter their death information here.

Do you know the exact date when the death occurred?

Yes

Year of death*

Decedent first name*

Decedent middle name

Decedent last name*

Gender*

Male

Female

Date of birth*

Has the decedent ever changed his/her name due to a marriage?

Yes

State of death*

City where the event occurred*

Your name and contact information

Whether you are seeking to apply for your death certificate or are submitting an application for another person (i.e. your child or spouse), please enter your name and contact information here.

First name*

Middle name

Last name*

Phone number*

Email address*

Confirm email address*

Address where you would like the birth death to be delivered

Street*

Apt, suite, floor, etc.

City*

State*

Zip Code*

Relationship to the person on record

What is your relationship with the person on the certificate?*

Why are you applying for a death certificate?*

By checking this box, I agree to submit the information provided to this website, and I authorize US Vitals Records to use my information to fill out all necessary documents to prepare my application materials. I understand that USVitalsRecords.com is a private document preparation service and that I am hiring them to prepare my certificate application materials. By providing my email address and cell phone number, I hereby agree to opt-in email/sms notifications including, but not limited to, application status updates and marketing emails. I understand there is a service fee charged by USVitalsRecords.com and for some specific state requirements, I will requires to pay the health department fee directly by check or money order. I understand I will have to provide additional documents or notarized documents to the health department to prove my identity. I understand that I may receive newsletters from USVitalsRecords.com. By submitting the form above, I agree to these terms and the terms of this website.