Menu Close

Death Certificate Request

    CERTIFICATE INFORMATION

    You are ordering the following Certified Copy:

    How Many Certified Copies Do You Require? Each Copy = $22 plus shipping

    Your role?

    Full Name at time of birth (required)

    Full Name at time of death (required)

    Date of Death (required)

    City in Muskingum County Where Death Occurred (required)
    Death certificates are only provided for Muskingum County deaths.

    Mother's name before first marriage (required)

    YOUR CONTACT INFORMATION
    This information will be used for receipt, mailing address, and future contact to complete your record request.

    Your Name (required)

    Shipping Method Requested (Shipping is charged to you, in addition to certificate fees)

    Your Street Address (required)

    City, State, Zip (required)

    Your Email (required for emailing receipt)

    Your Contact Phone Number (required if we have to reach you for any clarification)

    Online Payment Processing

    You will be directed automatically to PayPal once you send your request. This may take a few moments.
    If you are not redirected you may call 740-454-9741 x 280 and make payment over the phone 8am to 4pm.
    Your request will not be processed until we receive payment.


    Delivery Preference:
    Name On Certificate
    Your Name