California death certificate form pdf 2026

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  1. Click ‘Get Form’ to open the California Death Certificate Form PDF in our platform.
  2. Begin by completing the Applicant Information section. Fill in today’s date, your name, and signature. If applicable, include your agency name and case number.
  3. In the Mailing Address section, provide your complete address including city, state, and ZIP code. Ensure accuracy for proper delivery.
  4. Next, move to the Fetal Death Information section. Enter the fetal death's first, middle, and last names as known. Include the city and county of fetal death.
  5. Fill in the date of fetal death in MM/DD/CCYY format. If unknown, provide an approximate date.
  6. Indicate the sex of the fetus by selecting either Female or Male. Complete parental information with first, middle, and last names for both parents.
  7. Finally, indicate the number of copies requested and attach your payment (check or money order) securely to the form before mailing it to the specified address.

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The application can be obtained from the local county health department or from the California Department of Public Health. The application must be filled out completely and accurately, and it must include the deceased persons full name, Social Security number, date of death, and place of death.
Requests can be made in-person, by mail, or on-line. The Department of Public Health Vital Records is not able to process online orders, however, for your convenience, we have partnered with VitalChek Network to provide this service beginning January 11, 2021.
Ordering a death certificate Youll be asked to provide the full name of the deceased, the date and place of their death, and the GRO index reference number of the record if you have it. After paying a processing fee, youll get the death certificate sent to you by post or as a PDF via email.

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Sworn statements must be docHubd for authorized copy requests. Law enforcement, governmental agencies, and funeral establishments (for death records only) are exempt from the notary requirement, but must complete the top portion of the sworn statement page.
When youre submitting a request by mail or in-person, you must complete an application and affix a signed, docHubd affidavit proving your responsibilities as an estate administrator. Make sure to specify how many copies of the death certificate you need.
You will need to know the date and place of death. The state may also ask for other details about the person, how you are related to them, or why you want the certificate.

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