Arizona Death Certificate Application Form PDF 2024

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Arizona Death Certificate Application Form PDF 2023

The Arizona Department of Health Services, Bureau of Vital Records now accepts online orders in addition to expedited services. You can process online requests through an independent company that we have partnered with to provide you this service; VitalChek Network, Inc.

We do not endorse any other internet ordering service. VitalChek can be reached either through its website or by phone. An additional fee is charged by VitalChek for using this service, all major credit cards are accepted, including American Express®, Discover®, MasterCard®, or Visa®.

Arizona Death Certificate Online Ordering Options

The Arizona Department of Health Services, Bureau of Vital Records now accepts online orders in addition to expedited services. You can process online requests through an independent company that we have partnered with to provide you this service; VitalChek Network, Inc..

We do not endorse any other internet ordering service. VitalChek can be reached either through its website or by phone. An additional fee is charged by VitalChek for using this service, all major credit cards are accepted, including American Express®, Discover®, MasterCard®, or Visa®.

Service	Fee
Certificate Fee	$20.00 per certificate
Processing Charge Per Order	$15.50

*Note: Additional fees may apply for any applicable correction or amendment fees previously not collected. Please see the fee schedule for correction and amendment fees.

Arizona Birth Certificate Application Form PDF 2023

Service	Fee
Standard shipping via USPS	$0.00
Express Courier 2-3 Day Delivery	$17.50
Express Courier Standard Overnight (by 4 p.m.)	$18.50
Express Courier Priority Overnight (by 10:30 a.m.)	$19.50
Optional UPS Alternate Delivery Location (added to above express rates if chosen by consumer)	$5.00

How To Download Arizona Death Certificate Application Form PDF

Arizona Death Certificate Application Form PDF Link – Download PDF

Who Can Obtain a Arizona Death Certificate

Only persons 18 years of age or older may obtain a certified copy of a death certificate.

Note: An applicant presenting documents from a foreign country as proof of relationship or proof of legal interest must provide certified copies of the documents. Photocopies are not acceptable. If an evidentiary document is in a language other than English, it must be accompanied by:

• An English translation of the evidentiary document; and 
• A written statement signed by the translator, attesting that the translator is competent to translate the evidentiary document and that the English translation is an accurate and complete translation of the evidentiary document.

Arizona is a ‘closed record’ state. That means that vital records are not public record. Arizona law restricts the public’s access to vital records to protect the confidentiality rights of our citizens. Arizona Administrative Code (A.A.C.) R9-19-314 and R9-19-315 specifies that only the following persons may receive a certified copy of a death certificate:

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Apply For a Stillbirth or Fetal Death Certificate

See Who Can Obtain a Stillbirth or Fetal Death Certificate.

Apply in Person

The Arizona Department of Health Services Bureau of Vital Records (BVR) no longer provides same day walk in customer service. You may apply for a certified copy of a birth or death certificate by mail. If you would like same day walk in customer service please visit your local county health department Vital Records Office.

Apply by mail

To apply by mail you must submit the following:

• A completed
• Application for Certified Copy of a Death Certificate/Fetal Death Certificate/Certificate of Birth Resulting in Still Birth | Español
• A copy of your valid government-issued picture identification which bears your signature. Note: If you are not the parent named on the certificate, you must also bring proof of eligibility.
• Appropriate fee, according to the fee schedule. Acceptable payment methods are: cashier’s checks, money orders, Visa, or MasterCard. PLEASE DO NOT SEND CASH. Cashier’s checks and money orders must be for the exact amount and made payable to the Bureau of Vital Records. If you pay by credit/debit card, you must include the full card number and expiration date on your application.

Note: An incomplete application will delay the processing of your request.

Note: The average processing time for applications submitted through the mail is 15 to 20 business days from the date the application is received by the BVR.

Expedited Service (Applies to Fetal Death Certificates Only)

If necessary, you can also request expedited service.

more information about your eligibility to obtain a certified copy of a death certificate

Funeral Director or Funeral Director’s Designee

The Funeral Director or Funeral Director’s Designee is eligible to receive a certified copy of the deceased individual’s death certificate if the following criteria are met:

• The funeral director representing one of the following in a final disposition of the registrant’s human remains within 12 months after the registration of the registrant’s death:
  • The registrant, through a prearranged funeral agreement as defined in A.R.S. § 32-1301;
  • The registrant’s spouse;
  • The registrant’s parent, grandparent, or adult child, grandchild, brother, or sister; or
  • Another person who is responsible for the final disposition of the registrant’s human remains according to A.R.S. § 36-831; and
• A designee of the funeral director in subsection (B)(1);
• The funeral director or the funeral director’s designee shall submit a written request on the letterhead of the funeral establishment, or a completed, signed and dated death application that includes:
  • The name and license number of the funeral director.
  • Contact information for the funeral director (telephone number or email address).
  • The name and address of the funeral director’s establishment.
  • The registrant’s name currently listed in the registered death record.
  • The registrant’s date of birth and date of death.
  • If known, the:
    • Registrant’s sex;
    • State file number listed on the death record;
    • Town or city of the registrant’s death;
    • County of the registrant’s death; and
    • Deceased registrant’s social security number.
  • The number of certified copies being requested.
• The funeral director or the funeral director’s designee submits a photocopy of his/her valid government-issued photo identification which contains his/her name and signature or has his/her signature notarized on the written request.
• If the name of the funeral director or the funeral director’s establishment is not listed in the registrant’s death record, the funeral director or the funeral director’s designee must provide a copy of documentation demonstrating that the funeral director or the funeral director’s funeral establishment has a valid contract to furnish funeral goods or services, as defined in A.R.S. § 32-1301, related to a final disposition of the registrant’s human remains; and
• The fee in A.A.C. R9-19-105 for each certified copy requested.

Note: The Bureau of Vital Records and the County Vital Records may waive the identification/notary requirement for the funeral director or the funeral director’s designee signing the application, if a file for the funeral director or the funeral director’s designee is established and contains a copy of the funeral director’s or the funeral director designee’s valid government issued identification and documentation of current employment with the funeral establishment dated within twelve (12) months before the deceased registrant’s death was registered, and contains the name and address of the funeral establishment. 

All death certificates ordered by the funeral director or the funeral director’s designee must be sent directly to the funeral home and not the individual the funeral director or the funeral director’s designee is ordering for. Only the  funeral director or the funeral director’s designee, who is eligible to receive a certified copy of a deceased individual’s death certificate according to A.R.S. 36-324(A) and A.A.C. R9-19-314(B)(1) and R9-19-315(A), may order and pick up death certificates from the applicable County Vital Records Office.    

The funeral director or the funeral director’s designee may apply for a certified copy of a death record on behalf of a responsible person as stated in (B)(1)(d) above if the funeral director or the funeral director’s designee is representing the responsible person in the final disposition of human remains according to A.R.S. §36-831. Funeral directors or the funeral directors’ designee may not order death certificates on behalf of individuals other than specified in A.A.C. R9-19-314(B)(1)

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Spouse – Arizona Death Certificate Application Form

• The spouse’s name is included in the deceased individual’s death certificate.
• The spouse submits a copy of the marriage certificate for the deceased individual and the spouse.
• The spouse submits a signed application.
• The spouse provides valid government issued identification or notarized signature on the application.
• The spouse submits the appropriate fee(s).

Parent – Arizona Death Certificate Application Form PDF 2023

The parent is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• The parent’s name is included in the deceased individual’s death record.
  • If the parent’s name is not included in the death record, a copy of the deceased individual’s birth registration that lists the name of the parent or, if applicable, a certified copy of a court order of adoption or certificate of adoption or other court order naming the applicant as the deceased individual’s parent.
  • If the decedent was born in Arizona, the parent shall provide the name and date of birth of the decedent for verification (provided on the application) in the applicable electronic registry system. If the decedent was born in another state, a copy of the deceased registrant’s birth record that contains the name of the parent.
• The parent submits a signed application.
• The parent provides valid government issued identification or notarized signature on the application.
• The parent submits the appropriate fee(s).

Grandparent

The grandparent is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• The birth certificate of their child, the parent who is named on the deceased individual’s birth certificate and on the deceased individual’s death certificate, or, if applicable, a copy of a court order of adoption or certificate of adoption certified by the issuing court or other court order naming the deceased individual’s parent.
• If the grandparent’s child (mother or father named on the registrant’s certificate) was born in Arizona, the grandparent shall provide the name and date of birth of that child for verification in the applicable electronic registry system.
• The grandparent submits a signed application.
• The grandparent provides valid government issued identification or notarized signature on the application.
• The grandparent submits the appropriate fee(s).

Adult Child – Arizona Death Certificate Application Form PDF

The adult child is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• The adult child must be at least 18 years of age. If less than 18 years of age, provide proof of emancipation, according to A.R.S. Title 12, chapter 15, or proof of marriage (i.e. a certified court order that documents the individual has been emancipated or a marriage certificate that proves the person is married).
• Submit a copy of his/her birth certificate which names the deceased individual as the parent of the applicant, or, if applicable, a copy of a court order of adoption or certificate of adoption certified by the issuing court or other court order naming the deceased individual’s parent.
• If the adult child was born in Arizona, a search can be completed for the adult child’s record in the applicable electronic registry system to verify the record names the deceased individual as the parent of the applicant.
• The adult child submits a signed application.
• The adult child provides valid government issued identification or notarized signature on the application.
• The adult child submits the appropriate fee(s).

Grandchild – Arizona Death Certificate Application Form Download

The grandchild is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• The grandchild must be at least 18 years of age. If less than 18 years of age, provide proof of emancipation, according to A.R.S. Title 12, chapter 15, or proof of marriage (i.e. a certified court order that documents the individual has been emancipated or a marriage certificate that proves the person is married).
• The grandchild shall submit a copy of his/her birth certificate which names the deceased individual’s child as the parent of the applicant.
• The grandchild shall submit a copy of his/her parent’s birth/death certificate that links the grandchild to the deceased individual. If applicable, a copy of a court order of adoption or certificate of adoption, certified by the issuing court for the deceased individual or the deceased individual’s grandchild, etc. that shows the relationship to the deceased individual.
• If the births/deaths occurred in Arizona, a search can be completed in the applicable electronic registry system to verify the required information.
• The grandchild submits a signed application.
• The grandchild provides valid government issued identification or notarized signature on the application.
• The grandchild submits the appropriate fee(s).

Brother Or Sister

The brother or sister is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• The adult brother or sister must be at least 18 years of age. If less than 18 years of age, provide proof of emancipation, according to A.R.S. Title 12, chapter 15, or proof of marriage (i.e. a certified court order that documents the individual has been emancipated or a marriage certificate that proves the person is married).
• Submit a copy of his/her birth certificate which shows at least one common parent shared by the applicant and the deceased individual. If applicable, a copy of a court order of adoption or certificate of adoption, certified by the issuing court for the deceased individual or the deceased individual’s brother or sister, etc. that shows the relationship to the deceased individual.
• If the adult brother or sister child was born in Arizona, a search can be completed in the applicable electronic registry system for the adult brother or sister’s record to verify at least one common parent is shared by the applicant.
• The brother/sister submits a signed application.
• The brother/sister provides valid government issued identification or notarized signature on the application.
• The brother/sister submits the appropriate fee(s).

A person designated in a power of attorney

A person designated in a power of attorney, established by a person eligible according to A.A.C. R9-19-314(B)(3), (4), or (5) must submit the following to receive a certified copy of the deceased registrant’s death record:

• A copy of the power of attorney document; and
• As applicable, documentation demonstrating that the eligible person (e.g. surviving spouse, a parent, grandparent, adult child, grandchild, brother, or sister of the deceased individual) is eligible to receive a certified copy of the deceased registrant’s death record.
• A written request signed by the applicant
• A valid, government-issued photo identification which contains the applicant’s name and signature
  • If the applicant does not have a valid, government-issued photo identification, the written request must be notarized
• The fee in A.A.C. R9-19-105 for each certified copy requested.

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A Person Responsible for Final Disposition (Other than a Funeral Director)

A person who is responsible for the final disposition of the deceased individual’s human remains according to A.R.S. § 36-831 is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• A copy of documentation demonstrating that the responsible person meets the definition of a “responsible person” in A.R.S. §36-301.
• The responsible person submits a signed application.
• The responsible person provides valid government issued identification or notarized signature on the application.
• The responsible person submits the appropriate fee(s).

A Person Named as the Executor or Beneficiary of the Deceased Individual’s Estate

• A copy of the deceased individual’s last will and testament.
• The executor submits a signed application.
• The executor provides valid government issued identification or notarized signature on the application.
• The executor submits the appropriate fee(s).

A Beneficiary of the Deceased Individual’s Life Insurance Policy

A person named in as a beneficiary of a life insurance policy on the deceased individual is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• A copy of the life insurance policy for the deceased individual or other documentation from the company that issued the life insurance policy specifying the person as a beneficiary.
• The beneficiary submits a signed application.
• The beneficiary provides valid government issued identification or notarized signature on the application.
• The beneficiary submits the appropriate fee(s).

A person named in a court order

A person named in court order to receive a certified copy of the deceased individual death certificate is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• The person named in the court order submits a certified copy of the court order.
• The person submits a signed application.
• The person provides valid government issued identification or notarized signature on the application.
• The person submits the appropriate fee(s).

A Person Authorized by an Eligible Person

A person authorized in writing to receive a certified copy of the deceased registrant’s death record by a person who is eligible to receive a certified copy of the deceased registrant’s death record according to A.A.C. R9-19-314(B), (3), (4), (5) or (6) must submit the following to receive a certified copy of the death record:

• A written statement (letter) from the eligible person providing authorization to release the certified copy of the deceased registrant’s death record. The written statement shall include:
  • The deceased registrant’s name;
  • The name of and contact information for the person authorized to receive a certified copy of the deceased registrant’s death record;
  • The name of and contact information for the person who is eligible to receive a certified copy of the deceased registrant’s death record according to A.A. C. R9-19-314(B)(3 ), (4), (5), or (6) and who authorized the person to receive a certified copy of the deceased registrant’s death record; and
  • The notarized signature of the eligible person or a copy of a valid, government-issued photo identification which contains the name and signature of the eligible person
• A copy of documentation demonstrating that the eligible person is eligible to receive a certified copy of the deceased registrant’s death record;
• A written request signed by the applicant
• A valid, government-issued photo identification which contains the applicant’s name and signature
  • If the applicant does not have a valid, government-issued photo identification, the written request must be notarized
• The fee in A.A.C. R9-19-105 for each certified copy requested.

An insurance company / financial institution – Arizona Death Certificate Application Form

An insurance company or financial institution with which the deceased individual had a policy, account or other business relationship is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• An application or a letter on the letterhead of the insurance company or financial institution shall be submitted that includes:
  • The name and address of the insurance company, bank, credit union, mortgage lender, or other financial institution.
  • The name of and contact information for the insurance company’s, bank’s, credit union’s, mortgage lender’s, or other financial institution’s designee for the request (telephone number or e-mail address).
  • Name of the deceased individual.
  • Date of birth of the deceased individual.
  • Date of death of the deceased individual.
  • If known, the:
    • Sex of the deceased individual
    • The state file number listed on the certificate of death registration.
    • Town/city of the deceased individual’s death.
    • Place of the deceased individual’s death
    • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains.
    • The deceased individual’s social security number.
  • If applicable, a description of the policy the deceased individual had with the insurance company.
  • If applicable, a description of the account or other business relationship the deceased individual had with the bank, credit union, mortgage lender, or other financial institution.
  • The reason the insurance company, bank, credit union, mortgage lender, or other financial institution is requesting a certified copy of the deceased individual’s certificate of death registration.
  • As applicable, a copy of documentation demonstrating that the deceased registrant had an insurance policy with the company or an account or other business relationship with the company; and
  • The designee/applicant provides a valid government issued identification or notarized signature on the application or letter.
• The designee/applicant submits the appropriate fee(s).

A hospital or healthcare institution – Arizona Death Certificate Application Form

• An application or a letter on the letterhead of the hospital or healthcare institution shall be submitted that includes:
  • The name and address of the hospital or healthcare institution.
  • The name of and contact information for the hospital’s or healthcare institution’s designee for the request (telephone number or e-mail address).
  • Name of the deceased individual.
  • Date of birth of the deceased individual.
  • Date of death of the deceased individual.
  • If known, the:
    • Sex of the deceased individual
      • The state file number listed on the certificate of death registration.
      • Town/city of the deceased individual’s death.
      • Place of the deceased individual’s death
      • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains.
      • The deceased individual’s social security number.
  • A description of the claim against the deceased individual’s estate.
  • The reason the hospital or other health care institution is requesting a certified copy of the deceased individual’s certificate of death registration.
  • The designee/applicant provides a valid government issued identification or notarized signature on the application or letter.
• A copy of documentation demonstrating that the hospital or other health care institution has a claim against the deceased individual’s estate.
• The designee/applicant submits the appropriate fee(s).

A Person with a Court Order Having a Claim Against the Deceased Individual’s Estate

A person that has a court order with a claim against the deceased individual’s estate is eligible to receive a certified copy of the death certificate if all of the following criteria are met:

• An application or a letter from the person having the court order with a claim against the deceased individual’s estate that includes:
  • The name and contact information for the person that has the court order (telephone number or e-mail address)
  • If someone is submitting the request on behalf of the person that has the court order, the name of and contact information for the person’s designee for the request (telephone number or e-mail address).
  • Name of the deceased individual.
  • Date of birth of the deceased individual.
  • Date of death of the deceased individual.
  • If known, the:
    • Sex of the deceased individual
    • The state file number listed on the certificate of death registration.
    • Town/city of the deceased individual’s death.
    • Place of the deceased individual’s death
    • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains.
    • The deceased individual’s social security number.
  • A description of the claim against the deceased individual’s estate.
  • The reason the person is requesting a certified copy of the deceased individual’s certificate of death registration.
  • The person/designee provides a valid government issued identification or notarized signature on the application or letter.
• If applicable, a copy of documentation verifying that the designee is representing the person.
• A copy of the court order demonstrating that the person has a claim against the deceased individual’s estate.
• The designee/applicant submits the appropriate fee(s).

An Attorney Representing a Person Eligible to Receive a Certified Copy

An attorney representing a person who is eligible to receive a certified copy of the deceased registrant’s death record must submit the following to receive a certified copy of the deceased registrant’s death record:

• A written request, on the attorney’s letterhead paper or a death application that includes:
  • The attorney’s name and state bar number;
  • Contact information for the attorney, which includes a telephone number or an e-mail address;
  • The name of the person the attorney is representing;
  • The relationship of the person the attorney is representing to the deceased registrant;
  • The following information:
    • Name of the deceased registrant;
    • Date of birth of the deceased registrant;
    • Date of death of the deceased registrant;
    • If known, the:

• Sex of the deceased registrant;
• The state file number listed on the death record;
• Town or city of the deceased registrant’s death;
• Place of the deceased registrant’s death;
• Funeral establishment or person responsible for the final disposition of the deceased registrant’s human remains; and
• The deceased registrant’s social security number.
• If the attorney is representing a person in A.A.C. R9-19-314(B)(3) through (12), the number of certified copies of the registrant’s death record being requested; and
• The dated signature of the attorney, either:
  • With the attorney’s signature notarized; or
  • Accompanied by a valid, government-issued photo identification for the attorney that contains the attorney name and signature;
• A copy of the attorney’s retainer agreement with the person who is eligible to receive a certified copy of the deceased registrant’s death record;
• The applicable documentation demonstrating the eligibility of the person the attorney is representing to receive a certified copy of the deceased registrant’s death record; and
• The fee in A.A.C. R9-19-105 for each certified copy requested.

Consulate of a Foreign Government Request – Arizona Death Certificate Application Form

Note: All death certificates issued to any government agencies or entities shall be either printed or stamped “For Government Use Only” across the face of the certificate, including those charged a fee.

The consulate of a foreign government eligible to receive a certified copy of a deceased individual’s certificate of death registration according to A.A.C. R9-19-314 (B)(18) may request a certified copy of a deceased individual’s certificate of death registration on behalf of one of the person’s identified in A.A.C. R9-19-314(B)(3), (4), (5) and (6) by submitting to the State Registrar or a local registrar:

• A written request, on the letterhead of the consulate, that includes:
  • The name and address of the consulate;
  • The name of and contact information for the consulate’s designee for the request, which includes a telephone number or an e-mail address;
  • The name of the person the consulate is representing;
  • The relationship of the person the consulate is representing to the deceased individual;
  • The deceased individual’s:
    • Name in the deceased individual’s registered death record,
    • Date of birth, and
    • Date of death;
  • If known, the:
    • Sex of the deceased individual,
    • State file number,
    • Town or city of the deceased individual’s death,
    • County of the deceased individual’s death,
    • Place of the deceased individual’s death,
    • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains, and
    • Deceased individual’s Social Security Number;
  • The reason the person the consulate is representing is requesting a certified copy of the individual’s certificate of death registration;
  • The number of certified copies of the deceased individual’s certificate of death registration being requested; and
  • The dated signature of the consulate’s designee;
• Documentation (letter on the consulates letterhead) verifying that the consulate’s designee is representing the consulate;
• A written statement, signed by the consulate’s designee, attesting that the consulate has verified that the person they are representing is eligible under A.A.C. R9-19-314(B) (3), (4), (5) or (6) to receive a certified copy of the deceased individual’s certificate of death registration; and
• The fee in A.A.C. R9-19-105 for each certified copy of the deceased individual’s certificate of death registration being requested.

Government Agency Request – Arizona Death Certificate Application Form PDF 2023

Note: All death certificates issued to any government agencies or entities shall be either printed or stamped “For Government Use Only” across the face of the certificate, including those charged a fee.
A governmental agency processing a financial claim, a governmental benefit application, or another form of compensation on behalf of a deceased individual’s estate or having another official purpose for a noncertified copy of the deceased individual’s certificate of death registration may request a noncertified copy of the deceased individual’s certificate of death registration by submitting to the State Registrar or a local registrar:

• A completed, signed application or a letter of request on the governmental agency’s letterhead, that includes the following:
  • The governmental agency’s name and address
  • Contact information for the governmental agency (telephone number or an e-mail address)
  • The name in the deceased individual’s registered death record
  • The date of birth of the deceased individual
  • The date of death of the deceased individual
  • If known, the:
    • Sex of the deceased individual
    • State file number on the death certificate
    • Town/city of the deceased individual’s death
    • County of the deceased individual’s death
    • Place of the deceased individual’s death
    • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains
    • Deceased individual’s Social Security Number
  • A description of the:
    • Action the governmental agency is taking on behalf of the deceased individual or the deceased individual’s estate, or
    • Official purpose for which the governmental agency needs a certificate of the individual’s death registration
  • The reason the governmental agency is requesting a noncertified copy of the individual’s certificate of death registration, and
  • The dated signature of the governmental agency’s designee, accompanied by:
• A copy of the designee’s identification badge from the governmental agency verifying the designee is an employee of the governmental agency
• The governmental agency submits appropriate fee(s), unless the governmental agency is an exempt agency.

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Government Agency Fee Exemption

Effective July 1, 2009, The Bureau of Vital Records will no longer provide free copies (certified or noncertified) to non-Arizona State government agencies. A fee shall not be collected for requests submitted by a state government agency (i.e. Department of Economic Security, etc.), however, request(s) received from a county, federal, or foreign government shall be charged the fee required by Arizona Administrative Code (A.A.C) R9-19-105.

An Agency is defined in Arizona Revised Statutes (A.R.S.) § 41-1001 as “any board, commission, department, officer or other administrative unit of this state, including the agency head and one or more members of the agency head or agency employees or other persons directly or indirectly purporting to act on behalf or under the authority of the agency head, whether created under the Constitution of Arizona or by enactment of the legislature.

Agency does not include the legislature, the courts or the governor. Agency does not include a political subdivision of this state or any of the administrative units of a political subdivision, but does include any board, commission, department, officer or other administrative unit created or appointed by joint or concerted action of an agency and one or more political subdivisions of this state or any of their units.

To the extent an administrative unit purports to exercise authority subject to this chapter, an administrative unit otherwise qualifying as an agency must be treated as a separate agency even if the administrative unit is located within or subordinate to another agency.” This list of governmental agencies provides examples of Arizona state government agencies, which are exempt from paying the fee(s) and non-Arizona state government agencies, which would be required to pay the fee(s). You may also refer to the State of Arizona’s website for an agency directory of Arizona state government agencies.

more information about your eligibility to obtain a noncertified copy of a death certificate

Government Agency Request – Arizona Death Certificate Application Form PDF 2023

Note: All death certificates issued to any government agencies or entities shall be either printed or stamped “For Government Use Only” across the face of the certificate, including those charged a fee.
A governmental agency processing a financial claim, a governmental benefit application, or another form of compensation on behalf of a deceased individual’s estate or having another official purpose for a noncertified copy of the deceased individual’s certificate of death registration may request a noncertified copy of the deceased individual’s certificate of death registration by submitting to the State Registrar or a local registrar:

• A completed, signed application or a letter of request on the governmental agency’s letterhead, that includes the following:
  • The governmental agency’s name and address
  • Contact information for the governmental agency (telephone number or an e-mail address)
  • The name in the deceased individual’s registered death record
  • The date of birth of the deceased individual
  • The date of death of the deceased individual
  • If known, the:
    • Sex of the deceased individual
    • State file number on the death certificate
    • Town/city of the deceased individual’s death
    • County of the deceased individual’s death
    • Place of the deceased individual’s death
    • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains
    • Deceased individual’s Social Security Number
  • A description of the:
    • Action the governmental agency is taking on behalf of the deceased individual or the deceased individual’s estate, or
    • Official purpose for which the governmental agency needs a certificate of the individual’s death registration
  • The reason the governmental agency is requesting a noncertified copy of the individual’s certificate of death registration, and
  • The dated signature of the governmental agency’s designee, accompanied by:
• A copy of the designee’s identification badge from the governmental agency verifying the designee is an employee of the governmental agency
• The governmental agency submits appropriate fee(s), unless the governmental agency is an exempt agency.

Genealogical Research

A person who is a family member, including a niece or nephew, of a registrant, who is conducting research for genealogical purposes may request a noncertified copy of the registrant’s death certificate if all of the following criteria are met:

• The applicant is at least 18 years of age.
• Documentation demonstrating the applicant’s relationship to the registrant whose record they are requesting (i.e. one or more birth certificates, death certificates or a marriage certificate that show the person’s relationship to the registrant).
• For births or deaths in Arizona, provide information about the person or related person whose birth or death was registered in Arizona to assist in locating the registered records of the related person(s) in the applicable electronic registry system.
• Non-acceptable types of documentation to establish relationship:
  • Pedigrees, Lineage charts, Family trees.
• The applicant submits a signed application.
• The applicant provides valid, government-issued identification which contains the applicant’s name and signature or notarized signature on the application.
• The applicant submits the appropriate fee for each noncertified copy requested.

Note: The genealogist may obtain a copy of a birth certificate or death certificate on the Arizona Department of Health Services’ website http://genealogy.az.gov/ for registered birth certificates that are seventy-five (75) years after the person’s birth or a registered death certificate that is fifty years (50) after the person’s death.

Government Agency Fee Exemption – Arizona Death Certificate Application Form

Effective July 1, 2009, The Bureau of Vital Records will no longer provide free copies (certified or noncertified) to non-Arizona State government agencies. A fee shall not be collected for requests submitted by a state government agency (i.e. Department of Economic Security, etc.), however, request(s) received from a county, federal, or foreign government shall be charged the fee required by Arizona Administrative Code (A.A.C) R9-19-105.

An Agency is defined in Arizona Revised Statutes (A.R.S.) § 41-1001 as “any board, commission, department, officer or other administrative unit of this state, including the agency head and one or more members of the agency head or agency employees or other persons directly or indirectly purporting to act on behalf or under the authority of the agency head, whether created under the Constitution of Arizona or by enactment of the legislature.

Agency does not include the legislature, the courts or the governor. Agency does not include a political subdivision of this state or any of the administrative units of a political subdivision, but does include any board, commission, department, officer or other administrative unit created or appointed by joint or concerted action of an agency and one or more political subdivisions of this state or any of their units.

To the extent an administrative unit purports to exercise authority subject to this chapter, an administrative unit otherwise qualifying as an agency must be treated as a separate agency even if the administrative unit is located within or subordinate to another agency.” This list of governmental agencies provides examples of Arizona state government agencies, which are exempt from paying the fee(s) and non-Arizona state government agencies, which would be required to pay the fee(s). You may also refer to the State of Arizona’s website for an agency directory of Arizona state government agencies.