Form VS-31 "Application for a Certified Copy of Death Certificate" - Kentucky

What Is Form VS-31?

This is a legal form that was released by the Kentucky Department for Public Health - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 24, 2021;
  • The latest edition provided by the Kentucky Department for Public Health;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form VS-31 by clicking the link below or browse more documents and templates provided by the Kentucky Department for Public Health.

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Download Form VS-31 "Application for a Certified Copy of Death Certificate" - Kentucky

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VS-31 Rev. 3.24.2021
COMMONWEALTH OF KENTUCKY
STATE REGISTRAR OF VITAL STATISTICS
DEATH
APPLICATION FOR A CERTIFIED COPY OF DEATH CERTIFICATE
PRINT
Certificates of Death that occurred in Kentucky since 1911 are on file in this office
H
H
Please Print or Type Sections 1 through 12
RESET
DEATH CERTIFICATE INFORMATION
1. Full Name at Death
First
Middle
Last
2. Date of Death
Month
Day
Year
Age Last Birthday
3. Place of Death
Kentucky City or Town
Kentucky County
Name of Hospital (if any)
4. Attending Physicians
First
Middle
Last
Name
Name of Establishment
Address
Telephone Number
5. Funeral Service
Provider
Relationship
6. What is your relationship to the person whose certificate is being requested?
First
Last
7. Requestor’s Printed Name
Phone number with area code
8. Requestor’s Phone Number
Street Address
9. Requestor’s Mailing Address
City, State, Zip
10. Requestor’s City, State, Zip
11. Requestor’s Signature
DO NOT WRITE IN THIS SPACE
12. FEES – NON REFUNDABLE
Volume
A fee is to be paid for certified copies or records or for a search of the files or records when no
record is available. The fee for a certified copy of a death certificate is $6.00 U.S. Additional
Certificate
copies are $6.00 U.S. each. Make check or money order payable to “Kentucky State
Treasurer.” This fee is non refundable.
Year
Date
________ Certified Copies @ $6.00 each = $
How many
Total payment
Searched by
Certificates may also be ordered by the following methods:
In Person: The Office of Vital Statistics is located at 275 East Main Street in Frankfort. Visit our lobby and complete an application for a certified copy of
a birth, death, marriage or divorce certificate from 8 a.m. to 3:30 p.m. Eastern Time Monday through Friday.
Internet: Certificates may be ordered on the internet using a credit card (Visa, MasterCard, Discover or American Express) or check. An additional charge
card fee will apply. This is in addition to the fee for each certified copy requested. Certificates requested via internet,
https://www.vitalchek.com/death-
certificates/kentucky, may be delivered by overnight courier with payment of the additional shipment fee if that record is available.
Telephone: Orders may be placed by telephone using a credit card (Visa, MasterCard, Discover or American Express) or check. An additional charge card
fee will apply. This is in addition to the fee for each certified copy requested. Certificates requested via telephone may be delivered by overnight courier
with payment of the additional shipment fee. The telephone number to place your order is (800) 241-8322, choose option 1.
Mail: Orders are accepted by mail, using a check or money order in U.S. dollars drawn on a U.S. bank for payment. It can take up to 30 working days to
process your request from the date payment is posted. Mail to Vital Statistics, 275 East Main Street 1E-A, Frankfort, KY 40621. The Office of Vital
Statistics telephone number is (502) 564-4212.
Drop Box: The Office of Vital Statistics installed a drop box at the visitor entrance at 275 E. Main St., Frankfort for applications for certified copies of
birth, death, marriage and divorce certificates. Blank applications are provided on the drop box.
VS-31 Rev. 3.24.2021
COMMONWEALTH OF KENTUCKY
STATE REGISTRAR OF VITAL STATISTICS
DEATH
APPLICATION FOR A CERTIFIED COPY OF DEATH CERTIFICATE
PRINT
Certificates of Death that occurred in Kentucky since 1911 are on file in this office
H
H
Please Print or Type Sections 1 through 12
RESET
DEATH CERTIFICATE INFORMATION
1. Full Name at Death
First
Middle
Last
2. Date of Death
Month
Day
Year
Age Last Birthday
3. Place of Death
Kentucky City or Town
Kentucky County
Name of Hospital (if any)
4. Attending Physicians
First
Middle
Last
Name
Name of Establishment
Address
Telephone Number
5. Funeral Service
Provider
Relationship
6. What is your relationship to the person whose certificate is being requested?
First
Last
7. Requestor’s Printed Name
Phone number with area code
8. Requestor’s Phone Number
Street Address
9. Requestor’s Mailing Address
City, State, Zip
10. Requestor’s City, State, Zip
11. Requestor’s Signature
DO NOT WRITE IN THIS SPACE
12. FEES – NON REFUNDABLE
Volume
A fee is to be paid for certified copies or records or for a search of the files or records when no
record is available. The fee for a certified copy of a death certificate is $6.00 U.S. Additional
Certificate
copies are $6.00 U.S. each. Make check or money order payable to “Kentucky State
Treasurer.” This fee is non refundable.
Year
Date
________ Certified Copies @ $6.00 each = $
How many
Total payment
Searched by
Certificates may also be ordered by the following methods:
In Person: The Office of Vital Statistics is located at 275 East Main Street in Frankfort. Visit our lobby and complete an application for a certified copy of
a birth, death, marriage or divorce certificate from 8 a.m. to 3:30 p.m. Eastern Time Monday through Friday.
Internet: Certificates may be ordered on the internet using a credit card (Visa, MasterCard, Discover or American Express) or check. An additional charge
card fee will apply. This is in addition to the fee for each certified copy requested. Certificates requested via internet,
https://www.vitalchek.com/death-
certificates/kentucky, may be delivered by overnight courier with payment of the additional shipment fee if that record is available.
Telephone: Orders may be placed by telephone using a credit card (Visa, MasterCard, Discover or American Express) or check. An additional charge card
fee will apply. This is in addition to the fee for each certified copy requested. Certificates requested via telephone may be delivered by overnight courier
with payment of the additional shipment fee. The telephone number to place your order is (800) 241-8322, choose option 1.
Mail: Orders are accepted by mail, using a check or money order in U.S. dollars drawn on a U.S. bank for payment. It can take up to 30 working days to
process your request from the date payment is posted. Mail to Vital Statistics, 275 East Main Street 1E-A, Frankfort, KY 40621. The Office of Vital
Statistics telephone number is (502) 564-4212.
Drop Box: The Office of Vital Statistics installed a drop box at the visitor entrance at 275 E. Main St., Frankfort for applications for certified copies of
birth, death, marriage and divorce certificates. Blank applications are provided on the drop box.