Death Certificate Order Form

Instructions for Death Certificate Order Form

Carefully read these instructions before completing and submitting the Death Certificate Order Form.  Chapter 70.58A RCW and Chapter 246-491 WAC requires all applicants to be a qualified applicant, provide identity and proof of eligibility documentation, and provide required information to order a death certificate.

Checklist for completing the Death Certificate Order Form:
   • Complete all fields on the death certificate order form, sign, and date
   • A copy of your identity document(s)
   • A copy of your proof of eligibility document(s)

What is a qualified applicant?
A qualified applicant is a person who is eligible to receive a certificate.

Who are the qualified applicants for a long form death certificate?
Qualified applicants for a long form death certificate are: Spouse/Domestic Partner, Child, Parent, Stepparent, Stepchild, Sibling, Grandparent, Grandchild, Great Grandparent, Legal Guardian, Legal Representative, Authorized Representative, Next of Kin (if no one else from this list is living), Funeral Director or Funeral Establishment listed on the record (up to 12 months from the date of death), or Government Agency or the Courts (only for official duties).

Are you one of the qualified applicants listed above to the death certificate you are requesting?
If yes, continue. You will need to provide identity and proof of eligibility documentation.

**If you are not one of the listed above, STOP. You will not receive a WA State death certificate**

What is proof of eligibility documentation?
Proof of eligibility documentation are documents that link you to the requested death certificate.
   1. If you are listed on the record and your identity documentation sufficiently links you to the record
       (i.e. parents), your proof of eligibility requirement is met.
   2. If you are not listed on the record or your identity documentation doesn’t sufficiently link you to the
       record, you must provide additional documentation to prove eligibility.

What documents will Public Health & Social Services (PHSS) accept to prove eligibility?
PHSS will accept the following documents to prove eligibility:
   • Copies of vital records such as certifications of birth, death, marriage, and divorce from this or
      another jurisdiction that link you to the requested record
   • Copies of certified court orders from a court of competent jurisdiction linking you to the record (i.e.
      legal representative)
   • Document or letter from a government agency or courts stating the certification will be used in the
      conduct of official duties (for government and court officials only)

What identity documentation will PHSS accept?
PHSS will accept a copy of:
   • One government issued identity document (must contain photo, full name, and date of birth) that is
      current or expired less than 60 days; or
   • If you do not have a government issued identity document, then at least two alternate documents              from the alternate list.The alternate documents must contain matching first and last names and                addresses, or in combination contains full name,date of birth, and photograph.

What information is required?
The following information is required as it appears on the death certificate:
   • First and last name of the decedent
   • Date of death (mm/dd/yyyy)
   • City or county where the death occurred

Requestor Information

NAME OF PERSON ORDERING CERTIFICATE(S):

To receive a death certificate, you must indicate your relationship to the registrant below and sign the sworn statement that you are authorized to receive the certificate.

Select Relationship

Death Records Details

Disclaimer: Thurston County can access most Washington State death records from 2008 to present. Records prior to 2008 can be ordered from the Washington State Department of Health https://doh.wa.gov/licenses-permits-and-certificates/vital-records

 +
 +

Required Documentation

Proof of Identity *

Proof of Eligibility *
View the Proof of Eligibility (422-178)(PDF) for examples of how to prove qualifying relationship
 
En Español (DOH 422-178)

Certification *
Signature *
clear

Order Information

Death Certificates cost $25.00 each
 
Online orders process and ship via standard United States Postal Service mail within 3-7 business days after we receive full payment and all required documentation.  Missing information or documentation will delay orders.
**Fee for debit/credit card transactions is $2.00 or 2.35% (whichever is greater)



Current Total:
$0.00

Payment

**Fee for debit/credit card transactions is $2.00 or 2.35% (whichever is greater)
Visa

Office Use Only

 +
Secured by Formsite