Get Funeral Home Application For A Death Certificate

Filling out the Funeral Home Application For A Death Certificate online can streamline the process of acquiring vital records. This guide provides step-by-step instructions to ensure that users complete the application correctly and efficiently.

Follow the steps to complete the application accurately.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. In Part 1, enter the name of the funeral director or authorized representative. Include the first name, middle name, and last name, as well as the suffix if applicable. Next, provide the name of the funeral home and its license number. Fill in the street address, email address, zip code, state, city, and daytime phone number. Finally, select the relationship to the death record from the options provided.
3. In Part 2, input the deceased person's details. Record their name at death, social security number, sex, age at death, date of birth, and date of death. Specify the place of death, including the county, state, and city or borough.
4. Also in Part 2, provide the names of the deceased's parents under the PARENT/MOTHER’S NAME and PARENT/FATHER’S NAME sections. Include their first name, middle name, last name prior to first marriage, current last name, and suffix.
5. In Part 3, affirm that you have attached a legible photocopy of acceptable forms of identification, such as a valid driver’s license or another government-issued photo ID.
6. In Part 4, fill out the fee information. Calculate the total based on the quantity of certificates requested at $20.00 each. If requesting a fee waiver for an active or honorably discharged service member, indicate that accordingly.
7. In Part 5, sign and date the application. Ensure that the signature matches the name provided in Part 1. Read the affirmations carefully before signing.
8. Save your changes to the form. You may also choose to download, print, or share the form as needed.

Complete your documents online today for a streamlined application process.