Death Record Application

The Del Norte County Clerk Recorders office issues certified copies of death certificates of individuals who have passed away in Del Norte County to those who are entitled and also issue informational copies. Please review the instructions to insure timely process of your request.

1. If you are requesting an Authorized Certified copy, complete the entire form.If you are requesting a certified Informational Copy, complete only the Applicant Information and Registrant Information portion of this form.

2. If you submit your order in person, you must sign a sworn statement in the presence of Clerk-Recorder Staff.
If you submit your request by mail, you must complete the statement on the back of application and sign it in the presence of a Notary Public. PLEASE NOTE: Only one notarized sworn statement is required for multiple certificates requested at the same time; however, the sworn statement must include the name of each individual whose death certificate you wish to obtain and your relationship to that individual. (Note: A funeral director ordering copies on behalf of an individual specified in paragraphs (1) to (5), inclusive, of subdivision (a) of Section 7100 of the Health and Safety Code is not required to complete notarized statement.)

3. Use a separate application form for each different record of death you are requesting. If submitting your request by mail, remember to identify each certificate requested on the sworn statement.

4. Complete the Applicant Information section and provide your signature where indicated. Give all the information you have available to identify the record of the registrant in the spaces under Registrant Information. If the information you furnish is incomplete or inaccurate, it may be impossible to locate the record.

5. Submit $21.00 for each certified copy. If no record is found, the fee will be retained for searching as required by statute, and a Certificate of No Public Record will be issued. If you are mailing your request, indicate the number of certified copies you wish and include sufficient money with this application, in the form of a personal check, postal or bank money order (International Money Order for out-of-country requests), made payable to the Del Norte County Recorder. Mail this application, with the fee(s) AND A SELF-ADDRESSED STAMPED ENVELOPE to:

Del Norte County Clerk-Recorder
981 H Street, Suite 160
Crescent City, CA 95531

For questions you may call us at (707) 464-7216
County Website,
Apr 2, 2019, 9:13 AM