Application for Certified Death Record San Bernardino
This file provides the application form for obtaining certified copies of death records from San Bernardino County. It outlines the necessary information required, the relationship to the decedent, and submission guidelines. Ensure to complete the sworn statement as per legal requirements.
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How do I fill this out?
To fill out this form, begin by indicating your relationship to the registrant. Next, complete the sworn statement and ensure it is notarized if you're mailing your application. Finally, submit your payment along with the completed form.

How to fill out the Application for Certified Death Record San Bernardino?
1
Indicate your relationship to the registrant on the form.
2
Complete the sworn statement with required details.
3
Notarize the sworn statement if mailing the application.
4
Include payment of $21 for each copy requested.
5
Send your application, sworn statement, and payment to the appropriate address.
Who needs the Application for Certified Death Record San Bernardino?
1
Parents or Legal Guardians need this form to obtain authorized copies of the death record.
2
Surviving Next of Kin requires this form for estate management.
3
Attorneys may need this form to represent the estate during legal proceedings.
4
Law enforcement agencies use this form for official investigations and records.
5
Funeral establishment employees must fill this out to assist families with death record requests.
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What are the instructions for submitting this form?
To submit this form, complete all sections accurately and include your payment of $21. If mailing, attach a notarized sworn statement and send it to the Vital Statistics Section at 340 N. Mountain View Ave, San Bernardino, CA 92415-0038. Additionally, you may submit in person at the relevant office, ensuring that the sworn statement is signed in front of Vital Records staff.
What are the important dates for this form in 2024 and 2025?
Important dates for this application include new form updates annually in January. Stay informed about any changes in requirements or procedures each year to ensure compliance.

What is the purpose of this form?
The purpose of this form is to provide a standardized process for individuals to request certified copies of death records. This documentation is essential for legal and personal purposes, including estate management, legal representation, and family records. By ensuring proper completion and submission, authorized individuals can efficiently obtain the necessary records.

Tell me about this form and its components and fields line-by-line.

- 1. Relationship to Registrant: Indicates the relationship of the applicant to the deceased.
- 2. Applicant's Name: The full name of the person completing the application.
- 3. Decedent Information: Details about the deceased person, including name, date of birth, and date of death.
- 4. Contact Information: The address and phone number of the applicant for communication.
- 5. Sworn Statement: A declaration that must be completed and notarized to affirm eligibility.
What happens if I fail to submit this form?
Failing to submit this form correctly may result in delays or denial of your request for death records. It is crucial to ensure all required information and documents are included. Incomplete submissions may require you to resubmit, costing additional time and effort.
- Incomplete Application: Missing fields can lead to processing delays.
- Incorrect Payment: Ensure the payment is accurate and included with the application.
- Notarization Issues: Failure to notarize when required can result in rejection of the application.
- Lack of Required Documentation: Not providing necessary supporting documents can delay your request.
- Misidentification: Incorrect information can lead to the wrong records being processed.
How do I know when to use this form?

- 1. Legal Representation: Attorneys may require certified copies to manage estates.
- 2. Family Records: Family members often need this for personal records and genealogy.
- 3. Estate Management: Executors of estates may need to prove the death for legal proceedings.
- 4. Insurance Claims: Beneficiaries may require a death certificate for claims processing.
- 5. Government Benefits: Survivors may need the document to claim survivor benefits.
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How do I fill out the application form?
Fill out the form by indicating your relationship to the registrant and completing the sworn statement.
What payment options are available for this form?
Payments can be made via personal check or money order.
Is there a fee associated with obtaining a certified copy?
Yes, a fee of $21 is required for each copy requested.
What if I need multiple copies?
You can request multiple copies by indicating the quantity on your application form.
Who can witness my sworn statement?
The sworn statement must be notarized unless you are a law enforcement officer.
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