ID Requirements must be met before certificate is issued.
You will receive an email with instructions on how to send your ID within one week of submitting this application.
Items with an * asterisk are required fields.
City/County of Death:
Please select the exact city and county of death for the subject of the certificate.
Date of Death:
The exact date of death of the person listed on the certificate.
Year of Death Restriction:
For the selected county we can only accept orders for deaths that occurred from 2010 to 6 months before today's date.
The requestor is the person ordering the certificate. The name of the credit card holder must be the same as the requestor.
Date of Birth & Social Security Number of the Requestor:
This is an additional safeguard to protect your identity and the security of the requested certificate.
Valid SSN only, no ITINs or temporary SSNs permitted.
If you are not named on the record you may be required to provide proof of Relationship, Entitlement, and/or Court Documents.
The relationship selected must match your relationship to the subject exactly
Please visit our FAQ section for important information.
Name of Subject:
The name exactly as it appears on the certificate.
The Billing/Shipping Address and Name must match the Requestor's Information.
Telephone & Email Address of the Requestor:
ID requirements and other important information will be emailed to you. An incorrect email address will result in delays.
Does not include ID verification and delivery times.
UPS to Alaska, Hawaii or Puerto Rico is up to $27.50.
UPS Canada/Mexico is up to $28.00.
UPS to all international locations is up to $49.50.
Delivery method and price are subject to change based on delivery location
Regular mail delivery is available, however, we recommend you choose a more secure shipping method that provides faster delivery and tracking of your order.
State and Agency Fees are subject to change. Delivery Time Frames are not guaranteed and delivery to remote areas may take longer
1. I understand US Vital Records (USVR) offers professional advice and provides support to help
eliminate errors when applying for vital certificates. USVR assists in verifying that applications
are accurate to avoid delays in processing. USVR is not operated, licensed, or affiliated with any
2. I understand I will receive an email from the relevant government agency with instructions on how to send a copy of my government issued picture ID for verification.
3. I accept the Terms of Service, including the refund and cancellation policies.
Type your full name in the field below. Typing your full name constitutes a signature and an agreement
that you have read and agreed to all the provisions above. It additionally affirms that all information
provided on this order form is complete and accurate and that you are an authorized individual to
obtain the requested vital certificate.
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issues with your submission. Please review each issue below and make any necessary
corrections. Once you are satisfied with your submission, you may continue by
submitting the form again.