Get Az Death Registration Worksheet

The AZ Death Registration Worksheet is an essential document used to collect information required to complete the Arizona Certificate of Death. This guide will walk you through filling out the worksheet online, ensuring that you understand each section and field clearly.

Follow the steps to complete the AZ Death Registration Worksheet online.

1. Press the ‘Get Form’ button to access the AZ Death Registration Worksheet. This will open the form in your preferred editor for online completion.
2. Begin by filling out the personal information for the decedent. Enter their legal first, middle, and last names, along with any suffix, and indicate their gender by circling the appropriate option.
3. Next, provide the decedent's date of birth and date of death, selecting the correct unit of time (years, months, days, hours, or minutes) as applicable. Include the U.S. Social Security Number if available.
4. In the place of death section, specify the city or town, county, and zip code. Indicate the specific place of death, such as a hospital or residence, and provide details if it is an institution.
5. Complete the marital status section, entering the first, middle, and last names of the surviving spouse, along with their suffix and prior last name if applicable.
6. Select the education level of the decedent from the provided options.
7. Mark the decedent’s Hispanic origin and race. Make sure to check all applicable boxes for the decedent’s ethnic identity.
8. Provide the decedent’s birth information, including country, state, county, and city of birth.
9. Fill in the decedent’s residence address and indicate if they lived within city limits. Include information regarding how long they resided in Arizona and their occupation.
10. Complete the informant section by entering the information for the person filling out the form, including their relationship to the deceased.
11. Next, in the disposition section, fill out the date of final disposition and select the method(s) of disposition chosen for the decedent.
12. Complete the medical certification section by entering the date and time of death as well as cause of death information. Ensure that all relevant details related to any injuries and their circumstances are documented accurately.
13. Review all information for accuracy. Once all fields are completed, you can save changes, download, print, or share the form as necessary.

Complete the AZ Death Registration Worksheet online today to ensure accurate and timely processing of the death certificate.