Death Certificates

LillyState law authorizes the issuance of certified copies of vital records. Uncertified copies or verifications are not provided to the public.

State law also specifies that the initial $15.00 fee for a certified death certificate copy is a five-year record search fee – one certified copy is issued if the record is found and if not found, the fee is retained. You will receive either the certified copy or a letter explaining the search conducted and that no record was located.


NOTE: The documents listed below with * can be opened using Adobe Acrobat Reader, filled out on-line, and printed. The data will not be saved within the document.

The documents listed below with ** can be opened using Microsoft Office Word, filled out on-line, printed and saved.

English Application in Adobe *


English Application in MS Word **

Spanish Application in Adobe


Spanish Application in Word

If you experience problems downloading the files below, or wish to contact someone at The Office of Vital Statistics, please Email: