Division of Vital Records, Oklahoma State Department of Health
1000 Northeast 10th Street, Post Office Box 53551
Oklahoma City, Oklahoma 73152-3551

APPLICATION FOR SEARCH AND CERTIFIED COPY OF DEATH CERTIFICATE


Facts Concerning This Death

Facts Concerning This Death

PLEASE PRINT CORRECT MAILING ADDRESS BELOW:

Mailing address


Request for a search of the records for a death certificate of any person who died in the State of Oklahoma should be submitted on this blank along with the required fee of $10.00. If the death certificate is on file a certified copy will be mailed.

The information requested above should be filled in carefully and accurately. It is the minimum needed to make a thorough search for a death record.

Send ten dollars ($10.00) in cash, money order or check for each copy desired. Cash is sent at sender's risk. Make checks or money orders payable to the State Department of Health.

A copy required to be submitted to the Veterans Administration or U.S. Commissioner of Pensions, in connection with a claim for military-service-connected benefits may be obtained without fee provided a signed statement is attached which sets forth these facts and requests that the copy be issued without fee. Members of the armed forces and veterans must pay regular fees for copies to be used for all other purposes.

VS150 R8-93


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