Government of Ontario: Ministry of Government Services
Office of the Registrar General

REQUEST FOR DEATH CERTIFICATE
(For deaths which took place in Ontario only)

If you have any questions, please contact the
Office of the Registrar General
PO Box 4600 189 Red River Road
Thunder Bay ON  P7B 6L8
Outside Toronto: 1 800 461-2156 or in Toronto: 416 325-8305 or
Fax: 807 343-7459

(THIS SPACE RESERVED FOR OFFICE USE ONLY)




Please PRINT clearly in blue or black ink.
In the context of this form, the word 'Applicant' refers to the person completing this Request.

Applicant Name


Mailing Address





Telephone Number ( )
What Information are you Requesting and How much will it Cost?

This contains basic information, such as name, date and place of death.
$15.00 each                

This contains all information registered on the Statement of Death including signatures.
$22.00 each                

This contains all information registered on both the Statement of Death and Medical Certificate of Death including signatures and cause of death information.
$22.00 each                

A search results in a letter that either confirms a death registration exists or that there is no registration. If you don't know the exact date of death, choose a year based on information you may have obtained for this purpose, and write it in the space provided for the date. We will search that whole year plus two years before and after, for a total of five years. You may also request a search of additional years, in increments of five years.
       Each 5 years searched ................$15.00    
Information

If you're sending your payment from anywhere other than Canada, you must pay with an international money order in Canadian funds drawn on a Canadian clearing house, or by VISA, MasterCard or American Express. We will not accept post-dated cheques. We will charge $35.00 if your cheque is rejected because of insufficient funds. Please note that fees are subject to change without notice. If you send your request by mail, you can pay by cheque or money order, made payable to Minister of Finance, or by VISA, MasterCard or American Express. At our public counter, you can also pay by cash or debit card.

The Office of the Registrar General holds records for deaths that happened in Ontario during the past 70 years.

To obtain older records, contact:

The Archives of Ontario
Attention: Vital Statistics Reference Archivist
134 Ian Macdonald Boulevard
Toronto ON M7A 2C5
800 668-9933
416 327-1600

Your Payment Options "Minister of Finance"

Credit card payment: You must pay by credit card if you are faxing your request to us.
Our fax number is 807 343-7459.
     



Signature of Cardholder


Details of Deceased Person








If the person was married or in a common-law relationship at the time of death,
name of spouse or partner





Mother's Maiden Name





Father/Other Parent’s Name





Details of Applicant

(If you are only applying for a death certificate, please skip this section.)

If you are applying for a Certified Copy of a Statement of Death and/or a Medical Certificate of Death (Long Form or Extended Long Form), please indicate to which category of entitled individuals (see Instruction #1) you belong:

Next of Kin            

When you request a Certified Copy of Statement of Death, the Office of the Registrar General requires you to certify that you are the Next of Kin or if all the Next of Kin are deceased, you are the Extended Next of Kin.

,

.
I certify that I am the Next of Kin, or all of the Next of Kin are deceased, and I am the Extended Next of Kin.

Authorized Representative
Why are You Requesting this Information? (Select One)   
  

I authorize the Office of the Registrar General to issue the requested document/information, and consent to the Ministry of Government Services collecting information about myself and the person(s) named on the Record from such other sources as may be necessary to verify the information on this form and my entitlement to the service required, and to the disclosure of such information to the Ministry of Government Services. I am aware that it is an offence to wilfully make a false statement on this form.


Signature of Applicant


Daytime Telephone Number ( )


Personal information contained on this form is collected under the authority of the Vital Statistics Act, R.S.O. 1990, c.V.4 and will be used to provide certified copies, extracts, certificates, or search notices and to verify the information provided and your entitlement to the service requested and for security and law enforcement purposes. It is an offence to wilfully make a false statement on this form. Questions about this collection should be directed to: The Deputy Registrar General, Office of the Registrar General,189 Red River Road, PO Box 4600, Thunder Bay ON  P7B 6L8. Telephone Outside Toronto: 1 800 461-2156 or in Toronto: 416 325-8305 or Fax: 807 343-7459.

Instruction #1
Next of Kin are entitled to apply for a Certified Copy of a Statement of Death and/or a Medical Certificate of Death. Next of Kin include: *Spouse, **Common Law Partner, Mother, Father / Other Parent, Daughter, Son, Sister, and Brother.
If all of the above individuals are deceased, the Extended Next of Kin may apply. Extended Next of Kin include: Grandmother, Grandfather, Aunt, Uncle, First Cousin, Niece, Nephew or Grandchild.

*Spouse means either party to a marriage.
**Common Law Partner means two people living together continuously in a conjugal relationship outside of marriage for a period of no less than 3 years or two people who have lived together in a relationship of some permanence if they are the parents of a child.

Instruction #2
Authorized Representatives include an estate trustee, an executor or administrator, a person with power of attorney or a person with legal guardianship acting on behalf of the deceased or an entitled individual.

Instruction #3
Proof of Authorization includes a certificate of appointment of estate trustee, letters of administration, a will, proof of power of attorney and proof of legal guardianship.

Mail the Completed Request to:
The Office of the Registrar General
PO Box 4600
189 Red River Road
Thunder Bay ON  P7B 6L8
Fax. 807 343-7459

If you require faster service than 6-8 weeks, please apply online at www.serviceontario.ca