The Noncertified Death Record Application is the Hennepin County Vital Records Office form for ordering an informational copy of a Minnesota death record, printed on plain paper. Anyone may request one, and you enter what you know about the deceased person so the office can find the record. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; Hennepin County publishes the official PDF, and the application reaches the office through the channels described below.
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What is Noncertified Death Record Application – Hennepin County, MN?
The Noncertified Death Record Application is the form the Hennepin County Vital Records Office uses to take requests for noncertified copies of death records for deaths that occurred in Minnesota. A noncertified record prints on plain paper and is for informational use only.
The form has two blocks of entries. The first, marked mandatory, identifies the deceased person (name, date of death, date of birth or age, city and county of death, parents and spouse on record) and is used to find the requested record. The second identifies the requester and asks how many copies to order, how fast to process the request and how to pay.
If the office cannot find the record with the information you give, it sends a "Statement of No Record Found". Fees are due when you apply and are non-refundable. The form cites Minnesota Statutes, section 144.226 for the fees.
This form requests a death record only. It is not an application for a birth record, and the form does not describe any other type of copy. The revision printed on the form is 02/2026. A box for office use only (certificate number, number of copies, ID type and issue date) is filled in by the Vital Records Office, not by you.
Who needs to file Noncertified Death Record Application – Hennepin County, MN?
Anyone may buy a noncertified death record for a Minnesota death. The form sets no relationship, residency or eligibility requirement for the requester.
Use this form if you want an informational copy printed on plain paper. The form states that noncertified copies are for informational use only, so it does not fit a purpose that needs an official certified document.
Requesters who need the copy for Veterans' Affairs (VA) purposes can ask for a Veteran's Affairs (VA) certificate on the form; it is for VA purposes only and limited to 1 copy per request.
You must complete the requester section (name, daytime phone, email and mailing address) if you send the application to a vital records office by mail or fax. The mailing address must be one that UPS can deliver to: UPS will not deliver to PO boxes or APO addresses.
The form does not describe signing or applying on someone else's behalf.
When to file Noncertified Death Record Application – Hennepin County, MN
Submit the application whenever you need a noncertified copy of a Minnesota death record; the form prints no deadline. Fees are due at the time of application, and the Vital Records Office returns applications that are incomplete or not paid in full at that time.
You choose the processing speed on the form. Under Standard, your request is processed in the order received. Under Faster, your request goes ahead of standard requests for an additional fee, and that option does not include overnight mail delivery for the return of the record.
If the office cannot find the record with the information you provide, it sends a "Statement of No Record Found". The form states no processing time, so contact the office at 612-348-8919 or [email protected] with questions.
Documents you need
- Check or money order payable to Hennepin County Treasurer for the full amount due, sent by mail with the application. Do not send cash; enter the check or money order number on the form.
How to fill out Noncertified Death Record Application – Hennepin County, MN
Enter the deceased person's name
Under Subject/deceased, enter the first name, middle name and last name, all marked required, plus a name suffix if there is one.
Enter the death and birth details
Enter the date of death and the date of birth in MM/DD/YYYY format, or the age if you do not have the date of birth. Then enter the city of death, the county of death (required) and the state (required), which shows MN.
Add parents and spouse on record
Enter the first parent's name, the second parent's name and the spouse on record, if any. These details help the office find the record.
Complete the requester section
Enter your printed name, a 10-digit daytime phone number, your email and your mailing address with apartment or unit, city, state and ZIP Code. This section is a must if you send the application by mail or fax; UPS will not deliver to PO boxes or APO addresses.
Choose how many copies you want
Under Quantity and cost, enter the quantity for one noncertified copy and how many extra copies you want. Add a Veteran's Affairs (VA) certificate only for VA purposes, 1 copy per request.
Select the processing speed
Choose Standard, where your request is processed in the order received, or Faster, where it goes ahead of standard requests for an additional fee that does not include overnight return mail delivery.
Total the fees and choose payment
Enter the total due, then check Check or Money Order and write its number. Make it payable to Hennepin County Treasurer; the form says do not send cash.
Leave the office use box blank
The Office use only box (DCN/Certificate #, number of copies, initials, ID type, amount and issue date) is completed by the Vital Records Office.
Review and download the completed PDF
Check that the required name, county and state fields, your requester details and the total match your order. Download or print the completed PDF from FillingPDF and send it as described under How to submit.
How to submit Noncertified Death Record Application – Hennepin County, MN
The form lists two ways to send the application: mail and fax. Questions go to [email protected] or 612-348-8919.
- By mail: send the application and payment to Vital Records Office, Hennepin County Government Center, 300 South 6th St, MC- 678B, Minneapolis MN 55487-0678.
- By fax: the form lists FAX # 612-348-2010. The requester section must be completed whenever you mail or fax the application to a vital records office.
Payment: fees apply and must be paid in full when you apply; the amounts are on the form and the office can confirm them. Pay by check or money order payable to Hennepin County Treasurer, and send it by mail with the application. Do not send cash. Write the check or money order number in the payment section. A check returned for non-payment results in a charge to you and could bring civil penalties under Minnesota Statutes, section 604.113, subdivision 2.
The office returns applications that are incomplete or not paid in full. FillingPDF lets you fill out and download the PDF; submission follows the agency channels above.
Common mistakes to avoid
- Leaving the first, middle or last name of the deceased blank, or the county and state of death; the form marks these as required to find the record.
- Skipping the requester section when you send the application by mail or fax; the form says you must complete it in that case.
- Giving a PO box or APO address as the mailing address; the form says UPS will not deliver to them.
- Sending cash. The form says do not send cash; pay by check or money order payable to Hennepin County Treasurer.
- Paying less than the full amount for the copies and services you ask for; the office returns applications that are not paid in full.
- Expecting a refund. Fees are due at application and are non-refundable, including when no record is found.
- Choosing Faster processing and expecting overnight return delivery; that option does not include return overnight mail delivery.
- Asking for more than 1 Veteran's Affairs (VA) certificate per request, or using it for a purpose other than VA purposes.
- Using a noncertified copy where an official document is required; the form says noncertified copies are for informational use only.
Frequently asked questions
What is the Hennepin County Noncertified Death Record Application?
It is the Hennepin County Vital Records Office form for requesting a noncertified copy of a death record for a Minnesota death. The copy prints on plain paper and is for informational use only.
Is this the form for a Hennepin County birth certificate?
No. This form requests a noncertified death record only; it asks for the deceased person's name, date and county of death and related details. It does not cover a Hennepin County birth certificate, so look for that application at Hennepin County.
Who can request a noncertified death record in Hennepin County?
Anyone. The form states that anyone may buy a noncertified death record for a Minnesota death, and it sets no relationship requirement. The requester section asks for your name, phone, email and mailing address.
Where do I mail or fax the noncertified death record application?
Mail it with payment to Vital Records Office, Hennepin County Government Center, 300 South 6th St, MC- 678B, Minneapolis MN 55487-0678. The form also lists fax 612-348-2010. Complete the requester section if you mail or fax it.
How do I pay for a noncertified death record in Hennepin County?
Fees apply and are due when you apply. Pay by check or money order payable to Hennepin County Treasurer and mail it with the application; do not send cash. The amounts are printed on the form, and the office can confirm them at 612-348-8919.
What happens if Hennepin County cannot find the death record?
The office sends you a "Statement of No Record Found". The fees are non-refundable, so enter the deceased person's name, dates, county of death, parents and spouse as accurately as you can.
What does the Faster processing option do?
Faster puts your request ahead of standard requests, which are processed in the order received. It costs an additional fee and does not include overnight mail delivery for the return of the record.
Can I fill out the noncertified death record application online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not submit the form or take payment; you mail or fax it to the Hennepin County Vital Records Office yourself.
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