Arkansas Death Certificate Application Form – Fill Out and Use This PDF

Arkansas Death Certificate Application Form PDF Details

Obtaining a certified death record in Arkansas requires completing this application and submitting it to the Arkansas Department of Health. Use this form to request certified copies for legal, financial, and personal purposes.

Who Can Request an Arkansas Death Certificate

Access to certified death records is restricted. The following individuals are eligible to request a copy:

• The surviving spouse of the deceased
• A parent, child, or sibling of the deceased
• A legal representative or authorized agent
• A funeral home director handling final arrangements
• A government agency with a lawful need

All applicants must include a copy of a government-issued photo ID. This confirms your identity and your relationship to the deceased.

Information Needed on the Application

Accurate information is required to process your request. Missing or incorrect details can delay the search. Gather the following before filling out the form:

• Full legal name of the deceased
• Date of birth and date of death
• Place of death (city, county, and state)
• Name of the funeral home that handled arrangements
• Your full name, address, and phone number
• Your relationship to the deceased
• Your reason for requesting the certificate

Fees for Certified Copies

The Arkansas Department of Health sets the following fees for death certificate requests:

• First certified copy: $10
• Each additional copy ordered at the same time: $8

Pay by check or money order only. Do not send cash. A $10 non-refundable search fee applies even if the record is not found. A follow-up request with new information costs another $10 non-refundable fee.

How to Submit Your Application

You have four options for submitting the death certificate application in Arkansas:

• By mail: Send the completed form, a copy of your photo ID, and payment to the Arkansas Vital Records Office at 4815 W. Markham St., Little Rock, AR 72205.
• Online: Use VitalChek, the official state-authorized service. A convenience fee applies.
• By phone: Call VitalChek at 1-877-817-7364. Additional fees apply.
• In person: Visit the Arkansas Department of Health office in Little Rock for faster processing.

Processing Times

Standard mail requests take 4-6 weeks to process. Online, phone, and in-person requests are processed faster. If your need is urgent, choose an expedited method.

Records Availability

Arkansas vital records are available for deaths that occurred within the state. Records date back to before February 1, 1914, though older records may be incomplete. If you need to correct information on an existing certificate, a separate amendment process applies. Contact the Arkansas Department of Health for guidance.

Common Mistakes to Avoid

These errors commonly delay or void applications:

• Sending cash instead of a check or money order
• Failing to include a copy of your photo ID
• Leaving required fields blank on the form
• Providing incorrect dates or misspelling the name of the deceased
• Not stating your relationship to the deceased

Providing false information on this application carries serious penalties, including fines up to $10,000 or imprisonment.

If you need other Arkansas vital records, you may also want the Arkansas birth certificate application or the Arkansas small estate affidavit for estate matters after a death.