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Death Application

This document provides instructions for obtaining a certified death certificate from the Montana Office of Vital Records. Applicants must complete an application, provide valid identification, and specify the purpose for the certificate. Identification includes a driver's license, passport, or two forms with a signature. Certified copies cost $15 each while informational copies are $13. Fees must be paid by check made out to Montana Vital Records. The application requests the decedent's information, the applicant's relationship and mailing address, and signature.

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Beyza Gemici
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42 views

Death Application

This document provides instructions for obtaining a certified death certificate from the Montana Office of Vital Records. Applicants must complete an application, provide valid identification, and specify the purpose for the certificate. Identification includes a driver's license, passport, or two forms with a signature. Certified copies cost $15 each while informational copies are $13. Fees must be paid by check made out to Montana Vital Records. The application requests the decedent's information, the applicant's relationship and mailing address, and signature.

Uploaded by

Beyza Gemici
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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MONTANA OFFICE OF VITAL RECORDS

111 N SANDERS RM 6 / PO BOX 4210


HELENA, MONTANA 59604-4210
Phone: 406-444-2685
PLEASE READ THESE INSTRUCTIONS CAREFULLY
WHO CAN ORDER A DEATH CERTIFICATE?
Complete copies of a certified death certificate will be issued to anyone who submits a completed application, establishes their identity, and lists the reason for needing
the copy. If a death certificate lists the cause of death as "pending autopsy" or "pending investigation", a certified copy which has the cause of death information
removed will be issued.

IDENTIFICATION IS REQUIRED
The person signing the request must provide an enlarged legible photocopy of both sides of their valid driver’s license or other legal picture identification with a
signature or the requestor must have this application notarized.
Suggested Identification
Picture ID with a Signature OR Two Forms of ID – One MUST have a Signature OR
• Driver’s License • Social Security Card • Credit/Debit/ATM Card • Notarized Montana Office of Vital Statistics
• State ID Card • Work ID Card • School ID Card Statement to Identify certified Birth or Death
• Passport • Car registration/Insurance • Library Card Certificate Applicant form (you must
• Military ID Card • Doctor/Medical record • Insurance Record provide the original letter, not a photocopy
• Tribal • Fishing License • Pay Stub or faxed copy)
• US Military DD 214 • Traffic/ Pawn ticket • Have an authorized family member that has
• Utility Bill with a current address • Court record an ID order the certificate
• Voter Registration Card • Year Book
If a picture ID with a signature is not available, two other forms of identification are required; one MUST have a signature. Please include photocopies of both sides of
the ID when mailing your request
IMPORTANT: If the identification requirement is NOT met or if the application is incomplete, your request will be returned and significant delays in
processing your order may occur.

FEE (All fees must be U.S. funds)


• CERTIFIED COPIES OF A DEATH CERTIFICATE: Effective January 1, 2020 cost $15.00 each (non-refundable)
• INFORMATIONAL COPIES OF A DEATH CERTIFICATE the cost is $13.00. (non-refundable)
• CERTIFIED COPIES OF DOCUMENTS on file with the state (i.e., correction affidavits), the cost is $12.00. (non-refundable)

Please Make CHECKS Payable To: MONTANA VITAL RECORDS


Please complete the following information.
Decedent’s Name:
Date of Death (We need a date to begin searching if date is unknown): Date of Birth:
Place of Death: ________________________________Place of Birth:__________________________ Gender of Decedent____________________
Parents Names:
Occupation: Spouse’s Name:
Reason record is needed
Relationship:___________________________________ Number of Copies ___________Type of record needed?☐ Certified ☐ Not Certified
Mailing or Delivery Address:
Name:
Address: ___________________________________________ City, State, Zip:_________________________________________
Daytime Telephone Number: ______________________________Signature of Applicant: ________________________________
Email Address:______________________________________________________
____________________________________________________________________________________________________________
Notary (For use if needed) Verification of Signer’s ID Is Mandatory
State of ________________________ 0Official Use Only
County of ______________________ Date
This record was signed and sworn to (or affirmed) before me on ___________________ by Rec#
(Date)
_____________________________ Amount
_ (Name of Applicant) Cert #
Ser #
_____________________________
_ (Notary’s Signature) [Official Stamp] Comment

NOTICE: STATE LAW PROVIDES PENALTIES FOR PERSONS WHO WILLFULLY AND KNOWINGLY USE OR ATTEMPT TO USE THIS
CERTIFICATE FOR ANY PURPOSE OF DECEPTION. (50-15-114, MCA)

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