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How do I fill this out?
To fill out this form, you will need to provide specific details about the deceased and your contact information. Make sure to provide accurate and complete information to ensure timely processing. Follow the instructions carefully for each section.

How to fill out the Kentucky Death Certificate Application?
1
Enter the full name of the deceased.
2
Fill in the date and place of death.
3
Provide the attending physician's name and the funeral service provider's information.
4
Enter your relationship to the deceased and your contact details.
5
Sign and date the form.
Who needs the Kentucky Death Certificate Application?
1
Family members seeking a certified copy of a death certificate for legal purposes.
2
Executors of estates who need the death certificate for probate.
3
Insurance companies requiring proof of death for processing claims.
4
Genealogists conducting research on family history.
5
Government agencies verifying death details for official records.
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1
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What are the instructions for submitting this form?
Submit the completed form along with the payment to Vital Statistics, 275 East Main Street 1E-A, Frankfort, KY, 40621. Alternatively, order online via www.vitalchek.com/kentucky-express-birth-certificates.aspx, by phone at (800) 241-8322 option 1, or in person at the Vital Statistics office. Ensure all required fields are filled accurately to avoid delays.
What are the important dates for this form in 2024 and 2025?
Ensure to submit requests well ahead of deadlines to avoid delays. Check state-specific deadlines and plan accordingly.

What is the purpose of this form?
The purpose of this form is to provide a standardized method for requesting a certified copy of a death certificate in Kentucky. Individuals seeking this certificate may need it for legal, insurance, or personal purposes. The form collects essential details about the deceased and the requestor to process the request accurately.

Tell me about this form and its components and fields line-by-line.

- 1. Full Name at Death: The complete name of the deceased individual.
- 2. Date of Death: The date when the death occurred, including month, day, and year.
- 3. Place of Death: The location where the death occurred, including city, town, and county.
- 4. Attending Physicians: The name of the physician who attended to the deceased.
- 5. Funeral Service Provider: The name of the funeral service establishment handling the arrangements.
- 6. Relationship to Deceased: The requestor's relationship to the deceased individual.
- 7. Requestor's Contact Information: The contact details of the person requesting the certificate, including address and phone number.
- 8. Signature and Date: The signature of the requestor and the date of signing the form.
What happens if I fail to submit this form?
Failure to submit this form may result in delays or inability to obtain the required death certificate.
- Processing Delays: Your request may be delayed if the form is incomplete or not submitted in time.
- Inability to Obtain Certificate: Without the submitted form, you may not be able to get a certified copy of the death certificate.
How do I know when to use this form?

- 1. Legal Purposes: Needed for probate or other legal matters.
- 2. Insurance Claims: Required for processing life insurance claims.
- 3. Personal Records: Needed for personal record-keeping and genealogy research.
Frequently Asked Questions
How do I fill out the death certificate application?
Enter details about the deceased and your contact information, following the form's instructions.
Can I edit the death certificate PDF on PrintFriendly?
Yes, you can use PrintFriendly's built-in PDF editor to make changes directly on the form.
How do I sign the death certificate form on PrintFriendly?
Use PrintFriendly's digital signature feature to add your signature to the designated area.
Can I share the completed form using PrintFriendly?
Yes, PrintFriendly offers sharing options to email or download the completed PDF.
What information do I need to provide on the form?
You need to provide the deceased's details, attending physician's name, funeral service provider's information, and your contact details.
What is the fee for obtaining a certified copy of the death certificate?
The fee for a certified copy is $6.00 USD for each copy.
Where do I mail the completed form?
Mail the completed form to Vital Statistics, 275 East Main Street 1E-A, Frankfort, KY, 40621.
Can I order the death certificate online?
Yes, you can order it online using a credit card or check via www.vitalchek.com/kentucky-express-birth-certificates.aspx.
How long does it take to process the application by mail?
It can take up to 30 working days from the date payment is posted.
What are the office hours for walk-in orders?
The office accepts walk-in orders from 8:00 AM until 3:30 PM, Monday through Friday.
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