Last updated: 5/21/2025
Application For A Death Certificate
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Description
APPLICATION FOR A DEATH CERTIFICATE. This form is used to officially request a certified copy of a death certificate for an individual who has passed away in the state of Pennsylvania. This form is completed by individuals who are at least 18 years old or emancipated minors and who have a legal relationship to the deceased, such as a relative, legal representative, or estate administrator. Applicants may request a certificate either with medical information—including cause and manner of death, often used for legal or medical history purposes—or without medical information, which is typically used for administrative matters like closing accounts or transferring titles. The form requires identifying information about the deceased, such as their name, date of death, and place of death, along with the applicant’s contact details and proof of identity. It also includes instructions for submitting payment and outlines circumstances under which the $20 fee may be waived, such as for eligible military service-related requests. The completed form can be submitted online, by mail, or in person, and must be signed and dated by the applicant under penalty of law. www.FormsWorkflow.com
