Monroe County Vital Records

Death Certificate Order Form

Death must have occurred in Monroe County, NY.

* Required Fields

Whose death certificate are you ordering? *

Please be prepared to provide proof of relationship, if requested. Step-family members are not legally entitled.

My child's death certificate My parent's death certificate My spouse's death certificate - must be named on 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 *

Suffix

Gender: *

Date of Death: *

How many copies of this certificate are you ordering?* x $30 each