Navigating the procedural nuances of obtaining vital records can be a task fraught with legal and bureaucratic complexities, especially when dealing with sensitive documents like a death certificate. The Tennessee Department of Health's Office of Vital Records provides a structured avenue through which individuals can request a certified copy of a death certificate. The Application for Certified Copy of Certificate of Death encapsulates all the necessary details required from an applicant, including the full name of the deceased, date of death, sex, age at death, and place of death. Additionally, it demands information about the funeral home involved and specifies the relationship of the person making the request to the deceased. Importantly, the form contains a provision for indicating whether the cause of death is to be included on the certificate, a detail only accessible to direct relatives or legal representatives of the deceased's estate. A fee of $15.00 per copy is mandated, emphasizing the seriousness with which these requests are processed. This document is a critical tool for legal and personal matters, underscoring the importance of accurate information and adherence to Tennessee's legal framework when handling posthumous affairs.
| Question | Answer |
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| Form Name | TN Death Certificate Example Form |
| Form Length | 1 pages |
| Fillable? | Yes |
| Fillable fields | 78 |
| Avg. time to fill out | 15 min 55 sec |
| Other names | death certificate tennessee, atf i 5300 2 youth handgun safety act notice, tn death certificate application form pdf, certificate of death recent 2020 |
TENNESSEE DEPARTMENT OF HEALTH
OFFICE OF VITAL RECORDS
APPLICATION FOR CERTIFIED COPY OF CERTIFICATE OF DEATH
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Enclose $15.00 for each copy. |
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Full Name of Deceased: |
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First |
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Date of Death: |
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Sex: Male or Female |
Age at Death: |
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Place of Death: |
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Name of Funeral Home: |
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Location of Funeral Home: |
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Signature of Person Making Request:
Relationship to the Deceased:
Purpose of Copy:
Cause of Death is available only to the decedent's parent, child, spouse, or an attorney or agency acting on behalf of the decedent's estate or qualifying family member. Copies of any legal documents, where applicable, should also be submitted.
Do You Want the Certificate to Show Cause of Death? |
YES |
NO |
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Telephone Number Where You may be Reached for Additional Information: ( |
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IT IS UNLAWFUL TO WILLFULLY AND KNOWINGLY MAKE ANY FALSE STATEMENT ON THIS APPLICATION.
* Government Issued ID Required With Signature
A fee of $15.00 is charged for the search of the records even if no record is found and includes one copy if the record is filed in this office. If the certificate is not found with the date of death you provide, a search will be made in the records for the year before and the year after the date indicated; this search is routine and is included in the $15.00 fee. Do not send cash. Send a check or money order made payable to Tennessee Vital Records. In addition, unless this application is notarized, you must send a photocopy of a government issued ID showing your signature. If you have not received a response within 45 days, please write or call Tennessee Vital Records at
RDA 10112 |
FILL OUT BELOW/ DO NOT DETACH
PRINT name and address of person to whom the certified copy is to be mailed.SEND TO:
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Tennessee Vital Records |
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Andrew Johnson Tower. 1st Floor |
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710 James Robertson Parkway |
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Nashville, TN 37243 |
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DEPARTAMENTO DE SALUD DE TENNESSEE
OFICINA DE REGISTROS VITALES
SOLICITUD PARA COPIA CERTIFICADA DE PARTIDA DE DEFUNCIÓN
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Incluye $15.00 dólares por cada copia solicitada. |
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Nombre del difunto: |
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Primer nombre |
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Fecha de la defunción: |
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Sexo: Masculino o Femenino |
Edad cuando murió: |
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Adonde ocurrió la defunción: |
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Funeraria: |
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Local de la funeraria: |
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Firma de la persona que solicita la información:
Relación con el difunto:
El propósito de esta copia:
La causa de la muerte está solamente a la disposición del padre, del hijo o de la esposa del difunto, o de un abogado o agencia que funciona en nombre del patrimonio del difunto o de un miembro de la familia que esté autorizado. También se debe remitir copias de cualquier documento legal, donde convenga.
¿Usted quisiera que el certificado demostrara la causa de la muerte?
El número telefónico donde podemos comunicarnos:
Sí
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No
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ES ILEGAL HACER ALGUNA DECLARACIÓN FALSA CON CONOCIMIENTO DE CAUSA Y VOLUNTARIAMENTE EN ESTA SOLICITUD.
* Se necesita identificación oficial del gobierno con su firma
Se cobra una cuota de $15.00 por la búsqueda de los registros aún cuando no se encuentren e incluye una copia si el registro se archivó en esta oficina. Si el certificado no se encuentra con la fecha de la muerte que usted provee, se hará una búsqueda en los archivos del año anterior y del año después de la fecha indicada; esta búsqueda es rutinaria y se incluye en el pago de los $15.00. No envíe efectivo. Envíe un cheque o Money Order pagadero al Tennessee Vital Records. Además, a menos que esta solicitud sea certificada por un notario, usted debe enviar una fotocopia de alguna identificatión oficial emitida por el gobierno que enseña su firma. Si no ha recibido una respuesta dentro de 45 días, por favor escriba o llame al Tennessee Vital Records al
RDA 10112 |
LLENE ABAJO/NO LO SEPARE
ESCRIBA EN LETRA DE MOLDE el nombre y la dirección de la persona que recibirá la copia certificada
Nombre
Dirección o ruta
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Código postal |
ENVÍE A:
Tennessee Vital Records
Andrew Johnson Tower, 1st Floor 710 James Robertson Parkway Nashville, TN 37243