Illinois Death Certificate Application Form
This document provides a comprehensive guide for applying for a death certificate in Illinois. It outlines the necessary identification requirements, eligibility criteria, and the application process. Be sure to fill out the form correctly to ensure a smooth submission.
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How do I fill this out?
To fill out the Illinois Death Certificate Application Form, gather necessary identification documents and information about the deceased. Complete each section of the form accurately and include any required fees. Finally, ensure you sign the application before submitting.

How to fill out the Illinois Death Certificate Application Form?
1
Gather all necessary identification and information.
2
Complete the application form with accurate details.
3
Include the required fees based on the number of copies requested.
4
Sign the application to certify that all information is correct.
5
Submit the application to the appropriate address!.
Who needs the Illinois Death Certificate Application Form?
1
Family members looking to secure a copy of the death record.
2
Genealogists researching family history and lineage.
3
Lawyers managing estate issues requiring death verification.
4
Healthcare providers needing proof of death for records.
5
Organizations seeking uncensored historical records for research.
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What are the instructions for submitting this form?
To submit the application for an Illinois death certificate, mail the completed form along with a photocopy of your identification and payment to IDPH Vital Records, 925 E. Ridgely Avenue, Springfield, IL 62702-2737. Ensure your request is properly signed and dated. It is recommended to check the official website for any updates on submission procedures.
What are the important dates for this form in 2024 and 2025?
There are no specific important dates for this form in 2024 and 2025. However, it is advisable to keep updated on any changes to laws or fees that may affect the application process.

What is the purpose of this form?
The purpose of this form is to formally request a certified copy of a death certificate from the Illinois Department of Public Health. It is crucial for legal purposes, including settling estates, applying for benefits, and conducting genealogical research. Properly completing this application ensures that individuals receive the correct documentation necessary for their needs.

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

- 1. Full Name on Death Record: This field requires the deceased's full name as it appears on the death certificate.
- 2. Date of Death: Include the month, day, and year of the death.
- 3. Place of Death: Provide the city and county where the death occurred.
- 4. Requester Name: The individual filling out the application must provide their full name.
- 5. Address: Include the current address of the requester.
- 6. Requestor Relationship: Indicate your relationship to the deceased.
- 7. Payment Information: Provide the appropriate fees for the requested copies.
What happens if I fail to submit this form?
Failing to submit the form correctly may result in delays or denial of your request for a death certificate. It is important to ensure all information is filled out accurately and all required documents are included.
- Incomplete Information: Providing missing information may lead to your application being returned.
- Misidentification: Incorrectly identifying yourself or your relationship to the deceased may result in a denial.
- Payment Issues: Ensuring the correct fees are submitted is crucial, as insufficient payment will delay processing.
How do I know when to use this form?

- 1. Settling an Estate: Executors or beneficiaries need this document to administer the estate.
- 2. Claiming Benefits: Survivors may need the death certificate to claim life insurance or other benefits.
- 3. Genealogical Research: Those tracing family history often require death records for verification.
Frequently Asked Questions
What is the Illinois Death Certificate Application for?
This application allows individuals to request a certified death record from the Illinois Department of Public Health.
Who is eligible to apply for this document?
Eligibility typically includes immediate family members, legal representatives, and individuals with a genealogical interest.
What identification do I need to provide?
You need to submit a copy of a valid government-issued photo ID, along with any other required documents.
How much does it cost to obtain a copy?
The first certified copy costs $19, with additional copies available for $4 each.
How can I edit the application form?
You can edit the PDF using PrintFriendly by uploading it and using the edit features available.
Can I sign the document digitally?
Yes, PrintFriendly allows for digital signatures on PDF documents.
What if my request is denied?
If denied, you'll receive guidance on the reasons for denial and how to rectify your application.
How do I submit the application once completed?
You can mail the completed form along with payment to the address provided on the application.
Is there a way to track my application?
Tracking your application status is typically handled directly through the Illinois Department of Public Health.
What should I do if my ID is expired?
You may need to provide additional documents to verify your identity and current address.
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