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  • Mississippi Death Certificate Form

Get Mississippi Death Certificate Form

APPLICATION FOR CERTIFIED MISSISSIPPI DEATH CERTIFICATE Mississippi State Department of Health Vital Records P. O. Box 1700, Jackson, Mississippi 39215-1700 FIRST MIDDLE LAST DATE OF DEATH MONTH DAY.

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How to fill out the Mississippi Death Certificate Form online

Filling out the Mississippi Death Certificate Form online can seem daunting, but this guide will walk you through each component to ensure you complete it accurately. Whether you are requesting a copy for personal or legal reasons, this comprehensive guide will provide the necessary steps and explanations.

Follow the steps to fill out the Mississippi Death Certificate Form online:

  1. Press the ‘Get Form’ button to access the Mississippi Death Certificate Form online.
  2. Begin by entering the full name of the deceased. Include their first, middle, and last names.
  3. Indicate the date of death by filling out the month, day, and year in the respective fields.
  4. Provide the place of death, including the county, city or town, and state.
  5. Specify the sex and race of the deceased as required.
  6. Enter the social security number and age at the time of death.
  7. Fill in the names of the deceased's parents, specifically the name of the father and the name of the mother.
  8. Provide the name of the funeral director responsible for the arrangements.
  9. Complete the section for the person or facility requesting the copy and state their relationship or interest in the death record.
  10. State the purpose for which the certified copy is being requested.
  11. Sign the application to certify the information is accurate and complete.
  12. Date your application in the specified field.
  13. Prepare to submit the payment, ensuring it includes the nonrefundable fee as specified, and include a valid photo identification.
  14. After filling the form accurately, save your changes, download the completed form, print it for your records, or share it as necessary.

Ensure you complete your documentation accurately and efficiently—start filling out your forms online today!

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The state of Mississippi began recording deaths in 1912. One online statewide death index exists. Statewide Index to Mississippi Death Records, 1912-1943.

Obtaining a copy of a death certificate online is possible. There are several services such as SearchQuarry that will provide you with death records online. However, a majority of those copies are not official vital records.

Ordering Death Certificates Order on-line or by phone from a private vital records service, using a credit card. Come in person to our Ridgeland Office at 222 Marketridge Dr between 8:00 a.m. and 4:30 p.m. and pay by cash, check or money order. The record will be mailed within 7 to 10 business days of ordering.

Persons with tangible, legitimate, or direct interest may access and copy vital records held by the state and county officials within the State of Mississippi. These vital records include birth certificates, death certificates, marriage records, and death records.

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