Edit, Download, and Sign the Minnesota Death Certificate Request Form
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How do I fill this out?
To fill out the death certificate request form, first gather the necessary information about the deceased person. Next, carefully complete each section of the form, ensuring all required fields are filled out accurately. Finally, sign the form in front of a notary public if submitting by mail or fax.

How to fill out the Minnesota Death Certificate Request Form?
1
Gather necessary information about the deceased person.
2
Complete each section of the request form accurately.
3
Sign the form in front of a notary public.
4
Prepare your payment and include it with the application.
5
Submit the completed form via mail or fax.
Who needs the Minnesota Death Certificate Request Form?
1
Surviving spouses need this file to claim death benefits.
2
Parents may need it for insurance or estate claims.
3
Siblings might require it for settling family affairs.
4
Attorneys may use it for legal documentation related to a deceased client.
5
Government agencies may need it for official records or benefits.
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Edit this PDF on PrintFriendly by selecting the edit option after opening the document. You can modify text, add comments, or customize the layout as needed. Once done, simply download the edited document for your records.
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Select the edit option from the toolbar.
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Make necessary changes to the form fields.
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What are the instructions for submitting this form?
To submit your request for a death certificate, complete the application form with all required information. Send the completed form to the Minnesota Department of Health, Office of Vital Records via mail at PO Box 64499, St. Paul, MN 55164-0499. You may also fax your application to 866-416-1357 for credit card payments. Ensure payment is included with the request, and do not send cash. For faster processing, consider using express delivery services.
What are the important dates for this form in 2024 and 2025?
Ensure you keep track of important submission deadlines throughout 2024 and 2025. For instance, applications submitted during peak times may experience longer processing times. It’s advisable to apply early for any estate matters or legal processes.

What is the purpose of this form?
The purpose of this form is to officially request a copy of a death certificate from the Minnesota Department of Health. This document serves as a vital record for various legal and administrative purposes, including settling estates, claiming benefits, and record-keeping. Utilizing this form ensures that all relevant details are captured accurately to facilitate a smooth processing experience.

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

- 1. First name: Required first name of the deceased.
- 2. Middle name: Required middle name of the deceased.
- 3. Last name: Required last name of the deceased.
- 4. Date of death: Required date of death in MM/DD/YYYY format.
- 5. Date of birth: Date of birth or age of the deceased.
- 6. City of death: City where the death occurred.
- 7. Requester name: Full name of the person requesting the certificate.
- 8. County of death: County where the death record is stored.
What happens if I fail to submit this form?
Failure to submit this form correctly can lead to delays or complete rejection of your application. Ensure all required fields are accurately filled and that the form is signed where necessary. If the application is incomplete, the Office of Vital Records will return it for correction.
- Incomplete Application: If the application is not fully completed, it will be returned for corrections.
- Invalid Signature: A signature not verified by a notary public can cause the request to be invalid.
- Incorrect Payment: Submitting incorrect fees may delay processing or result in application rejection.
How do I know when to use this form?

- 1. Estate Management: To settle the estate of the deceased, an official death certificate is often required.
- 2. Insurance Claims: Claiming various insurance benefits may necessitate a death certificate.
- 3. Government Benefits: Surviving family members may need it to access government benefits.
Frequently Asked Questions
How do I request a death certificate?
Complete the request form with accurate information about the deceased and submit it along with payment.
What information do I need to provide?
You'll need the deceased's full name, date of birth, date of death, and your relationship to them.
Can I edit the PDF before submitting?
Yes, you can easily edit the PDF using PrintFriendly's editing tools.
How long will it take to process my request?
Processing times vary, but standard requests are handled in the order received.
What payment methods are accepted?
Payments can be made by credit card, check, or money order.
Can I submit my request online?
You can submit by mail or fax, but online submission is not currently available.
What happens if my request is incomplete?
Incomplete requests will be returned, and the application must be resubmitted with proper details.
How can I track the status of my request?
Contact the Office of Vital Records for updates on your application status.
Is there a fee for multiple copies?
Yes, additional copies of the death certificate incur a nominal fee.
How do I know if I am eligible to request a certificate?
Eligibility is based on your relationship to the deceased and the purpose of the request.
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