Monroe County, NY Vital Records : Birth & Death Certificates
Death Certificate Order Form
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* Required Fields
Whose death certificate are you ordering?
*
Please be prepared to provide proof of relationship, if requested.
My child's death certificate
My parent's death certificate
My spouse's death certificate
My sibling's death certificate
Other
If relationship is "other," please call our office at 585-753-5141.
Name (as it appears on certificate):
*
First
*
Middle
Last
*
Jr.
Sr.
I
II
III
IV
V
Suffix
Gender:
*
Male
Female
Date of Death:
*
How many copies of this certificate are you ordering?
*
x $30 each
