Free Legal Forms
| Death Certificate, Request for |
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Date: To: Whom It May Concern: Please forward to my attention a certified death certificate for: Exact Name: Date of Death: Town or City of Birth: Sex: I am the Executor or Trustee acting on behalf of the Estate of the Deceased. A copy of my authorization is enclosed. Enclosed is my credit card information for your use to pay for my request: Credit Card Number: Expiration Date: Exact Name on Card: If you require a check instead, please send me the amount due in the enclosed stamped self-addressed envelope and I will send it to you by return mail. Thank you for your assistance in this matter, Best regards, _____________ Executor or Trustee Enc. Authority to Act |
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