Your Information - Vital Records

APPLICATION FOR CERTIFIED COPY OF DEATH CERTIFICATE

The Office of Vital Records has been registering deaths for persons born in Nebraska since 1904.

WARNING

Please view Nebraska Revised Statutes (Section 71-649) before requesting a record. It is a felony to obtain, possess, use, sell, furnish, or attempt to obtain any vital record for purposes of deception.

If this death is pending investigation an abstract of death will be issued. This transaction will not be refunded or exchanged.

Abstract of Death FAQ

Your Information: Your name must match ID name

First Name

Middle Name

Last Name

Suffix

Daytime Phone Number

Email Address

Is Physical Address an APO or International Address?

Yes No

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Full Legal Name

Street Address or Post Office Box Number

City or Town Name, other Principal Subdivision (i.e. Province, State, County, Etc.) and Postal Code (if known)

Country Name

Is Shipping Address an APO or International Address?

Yes No

Shipping Address

Address Line 1

Address Line 2

PO Box

City

State

Zip Code

Full Legal Name

Street Address or Post Office Box Number

City or Town Name, other Principal Subdivision (i.e. Province, State, County, Etc.) and Postal Code (if known)

Country Name

A copy of your current Government Issued ID is required to continue with this application.*
Please review the acceptable forms of documents here: ?

Upload Documents ?

Allowed file extensions: .tiff, .tif, .pdf, .doc, .docx, .jpg, .jpeg, .png and .gif
Max file size allowed: 20 MB.

Uploaded Documents

Vital Records - Certificate Requests

Department of Health and Human Services

Division of Public Health Vital Records

The Office of Vital Records has been registering deaths for persons born in Nebraska since 1904.

Your Information: Your name must match ID name

Physical Address

Shipping Address