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Authenticated Michigan Death Record - Mail Or Counter Application For A Authenticated Or Apostilled Copy Form. This is a Michigan form and can be use in General Statewide.
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Tags: Authenticated Michigan Death Record - Mail Or Counter Application For A Authenticated Or Apostilled Copy, Michigan Statewide, General
APPLICATION FOR AN
MICHIGAN DEATH RECORD
AUTHENTICATED OR APOSTILLED COPY
INFORMATION ABOUT AUTHENTICATED CERTIFICATES - Authenticated (exemplified or containing an apostille) records
are typically required by foreign governments for an adoption, work visas, marriage in a foreign country, or establishing residency. You must specify which country requires the document. Applying the “apostille” at the Secretary of State’s Office of the
Great Seal takes an additional 2-3 weeks after processing in Vital Records is completed.
PART 1:
APPLICANT’S INFORMATION
(Person Requesting Record)
Applicant’s
Name:______________________________________________________________________________________________
Mailing Address: ______________________________________ City: ____________________ State: _____ Zip: ________
Daytime Phone (
PART 2:
) ________________________________ Other Phone: (
) ________________________________
CERTIFICATION OF INFORMATION PROVIDED
By signing this application, I understand that I am agreeing to pay for a search of the State of Michigan Vital Records with the
information that I provided. This does not guarantee that a record will be found.
► Applicant’s Signature: _________________________________ Date: __________
PART 3: PURPOSE FOR REQUESTING THE RECORD
PART 4: SPECIFY COUNTRY OF USE
PART 5: DEATH INFORMATION NEEDED TO FIND THE RECORD
If the exact date of death is unknown, please indicate the year you want searched. If you need additional years searched, please see Part 6
payment box for fee information. We can do a search without the “county” of death, but it may not be a thorough search.
NAME OF DECEASED
(Name at time
of death)
DATE OF BIRTH (If Known)
First
GENDER
□
□
Male
Middle
Last
(mm/dd/yyyy)
DECEDENT’S PLACE
OF DEATH
Female
DATE OF DEATH
mm/dd/yyyy)
Other variations of same name or locations:
City
County
State
Please provide any of the following additional information (if known) that would help us locate the death record:
DECEDENT’S
PLACE OF BIRTH
DECEDENT’S SOCIAL SECURITY NUMBER
State
Country
DECEDENT’S
MOTHER’S NAME
___ ___ ___
___ ___
___ ___ ___ ___
DECEDENT’S
FATHER’S NAME
First
Middle
Last
First
Middle
Last
PART 6: FEES - Includes one certified copy or no-find letter
Base Fee:
Includes One Year Search
$42.00
$ 42.00
Additional Certified Copies (Each)
____ x $26.00
$
Additional Years Search (Number of years)
____ x $12.00
$
(when exact year unknown)
Indicate years you want searched: _____ _____ _____ _____
EXPEDITED “RUSH” SERVICE (Additional)
$25.00
$
For Accounting Use Only
PAYMENT TO “STATE OF MICHIGAN”
TOTAL:
Is your request complete? See checklist on back!
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HAVE YOU DOUBLE CHECKED ??
PART 1: Print your name and mailing address
Cannot send to general delivery addresses
Include a telephone number to reach you
PART 2: Sign your name
Do not print. Signature required.
PART 3:
Fill out purpose for requesting the record
PART 4: Specify COUNTRY of use
PART 5: Complete all items
“Unknown” if information unavailable
“N/A” if not applicable
PART 6: Fees
Please total all fees correctly
PAYMENT
Check or money order made payable to the “State of
Michigan”
APPLYING IN PERSON
LOCATION:
Capitol View Building, 3rd Floor
201 Townsend Street
Lansing MI 48913 (across from the State Capitol)
LOBBY HOURS: 8:00 am - 5:00 pm M-F except for recognized state holidays.
DIRECTIONS: Visit our website at: www.michigan.gov/
vitalrecords or call 517-335-8666.
SAME DAY SERVICE: Same day service is not available
for an authenticated record; however, you do have the option
of requesting a regular certified copy ($46 order placed before
2:00 pm) and then personally walking it to the Office of the
Great Seal (2 blocks) to have the apostille affixed. Please
allow up to a 2 hour waiting period for the order to be processed in our office. Genealogy requests may take longer.
PROCESSING TIMES FOR MAIL REQUESTS
REGULAR SEARCH – The processing time for a regular request will
be approximately 5 weeks, depending on the volume of requests received.
EXPEDITED (RUSH) SEARCH – The processing time for a “rush”
request will be approximately 2 weeks, depending on the volume of
requests received.
APOSTILLES - Applying the apostille at the Secretary of State’s Office of the Great Seal for any request takes an additional 2-3 weeks
after processing in Vital Records is completed. If you request just a
certified copy from our office before 2:00 pm, you can go in person
(two blocks) and have the apostille applied same-day.
ADDITIONAL INFORMATION - If you find that the processing times
listed do not meet your needs, please call our Eligibility Unit at 517335-8666 and speak with a customer service representative. They
may be able to offer additional help to meet your individual situation.
MAIL APPLICATION TO
REGULAR MAIL TO:
Vital Records Requests
PO Box 30721
Lansing MI 48909
RUSH MAIL TO:
Vital Records RUSH
PO Box 30721
Lansing MI 48909
REQUESTING A MICHIGAN DEATH RECORD
The Michigan Vital Records office has records of deaths that occurred
in Michigan and were filed with the state since 1867. Occasionally,
some of the records were not filed with the state; more records are
missing from the pre-1906 files.
Death records are not restricted documents in Michigan. Anyone can
request that a search be conducted if the application is completed
and signed, and submitted with the required fee paid.
PAYMENT: A money order, credit card or cash can be
used at our front counter. A personal check can also be used
if the request is NOT same-day service.
PAYMENT INFORMATION
SEARCH FEES ARE NON-REFUNDABLE: Fees are established by state statute. The base fee includes a statewide
search of one year and either one certified copy of the record
or an official statement that the record is not filed with the
state.
REFUNDABLE FEES: Payment for additional copies will be
refunded if the search indicated that the record is not filed
with the state. A refund check would be mailed to you by the
Michigan Department of Treasury, usually within 3-6 weeks.
RUSH SERVICE: Applies to processing time in Vital Records. For a mail-in request, applying the “apostille” at the
Office of the Great Seal takes an additional 2-3 weeks after
processing in Vital Records is completed.
www.michigan.gov/vitalrecords
517-335-8666
DCH-0569-DX-AUTH Rev 11-2015
By Authority of MCL 333.2882(1)©, MCL 333.2883(2) and MCL 333.2891(1-4)
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