Indiana
Application for Search of Certified or Non-Certified Copy of a Death Record
No One Left Outside provides source-based information. The issuing agency or plan decides eligibility, acceptance and availability.
Source / last checked Vital Records: Order Certificates - 2026-11-02
- Form number
- 49606
Vital Records: Order Certificates - Reviewed 2026-11-02
- What it is for
- Application for Search of Certified or Non-Certified Copy of a Death Record
Vital Records: Order Certificates - Reviewed 2026-11-02
- Issuing agency
- Indiana Department of Health, Division of Vital Records
Vital Records: Contact Us - Reviewed 2026-11-02
- Program
- Indiana birth and death records
Vital Records: Order Certificates - Reviewed 2026-11-02
- Jurisdiction
- Indiana
Vital Records: Order Certificates - Reviewed 2026-11-02
- Category
- Birth/death certificate request
Vital Records: Order Certificates - Reviewed 2026-11-02
- Form type
- Form
Vital Records: Order Certificates - Reviewed 2026-11-02
- Who fills it out
- Applicant
Application for Search of Certified or Non-Certified Copy of a Death Record - Reviewed 2026-11-02
- How to submit
- Print and mail the request form; the page says the form contains the mailing address.
Vital Records: Order Certificates - Reviewed 2026-11-02
- Documents to include
- *IDENTIFICATION IS REQUIRED according to 410 IAC 18-4-2. Requests for death certificates sent without proper identification will be returned to the requester without processing. APPLICANT MUST PROVIDE A COPY OF THE FRONT AND BACK OF THE IDENTIFICATION OR THE APPLICATION WILL BE REJECTED. *Please complete all items below as required pursuant to IC 16-37-1- 10 (a).
Application for Search of Certified or Non-Certified Copy of a Death Record - Reviewed 2026-11-02
- Languages
- English
Application for Search of Certified or Non-Certified Copy of a Death Record - Reviewed 2026-11-02
- Official page
- https://www.in.gov/health/vital-records/order-now/
Vital Records: Order Certificates - Reviewed 2026-11-02
- Direct form link
- https://forms.in.gov/Download.aspx?id=5621
Vital Records: Contact Us - Reviewed 2026-11-02
- Revision date
- R11 / 7-26
Application for Search of Certified or Non-Certified Copy of a Death Record - Reviewed 2026-11-02
- Signature
- Printed Name of Applicant Signature of Applicant
Application for Search of Certified or Non-Certified Copy of a Death Record - Reviewed 2026-11-02
- Accessibility
- Not listed yet. Call to confirm.
- What the form says
<p>The form includes applicable <a href="/health/vital-records/" target="_blank" rel="noopener">fees</a>, identification requirements, and the mailing address. The cost for the first certificate is $10.00 and $4.00 for each additional copy. Please make checks payable to the Indiana Department of Health.</p>
Vital Records: Order Certificates - Reviewed 2026-11-02
Check the form number and revision before using it. Read the agency's privacy and consent terms before sharing personal information.