The Application for Copy of West Virginia Death Certificate is the form used to ask West Virginia Vital Registration, at the DHHR Bureau for Public Health, for copies of a death certificate. It asks who is on the certificate, who you are in relation to that person, how many copies you want and where to send them. It is one of the West Virginia vital records request forms, and death records are confidential in most cases. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form itself is published by the agency at dhhr.wv.gov.
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What is Application for Copy of West Virginia Death Certificate?
The Application for Copy of West Virginia Death Certificate is the request form that West Virginia Vital Registration uses to receive orders for copies of a death certificate, identifying the person on the certificate, the requestor, the number of copies and the payment.
The form has two parts. The first asks for the information found on the certificate being requested: the name of the person (first, middle, last), the date of death, the city, county and state, and sex. The second asks about the person requesting it: relationship to the decedent, signature and printed name, reason for the request, number of copies, a return address, daytime telephone number and e-mail address.
Death records are confidential and not open to the general public, except for those that are at least 50 years old. For that reason the form requires photo identification with every order and proof of relationship when you are ordering a certificate other than your own. The form warns that false statements and misuse of vital records result in criminal and civil penalties under WV Code §16-5-38.
A fee per copy applies, paid by check or money order. The agency's forms pages list correction and amendment forms separately, so this application is only for ordering copies, not for changing a certificate.
Who needs to file Application for Copy of West Virginia Death Certificate?
The people the form lists as entitled to obtain a West Virginia death record are:
- the informant listed on the death certificate;
- parents and grandparents;
- adult children and grandchildren;
- adult siblings;
- the spouse; and
- legal representatives, who must also provide proof of legal representation.
Proof of relationship may also be required, and the form asks you to enclose it if you are ordering a certificate other than your own. On the form you mark your relationship: Parent, Guardian or agent, Grandparent, Child of decedent, Spouse, or Other (Describe).
Death records are confidential and not open to the general public, except those at least 50 years old. If you are not in one of the groups above and the record is under 50 years old, the form gives you no basis to request it. Every requestor must supply valid ID, as listed under Required documents.
When to file Application for Copy of West Virginia Death Certificate
No deadline is printed on the form: you submit it whenever you need copies of a West Virginia death certificate and can enclose your photo identification, proof of relationship where needed, and payment. Confidentiality depends on the age of the record: death records are not open to the general public unless they are at least 50 years old, so the date of death you enter affects who may order. The form gives no processing time. For questions about an order, the form lists the Vital Registration information line at (304) 558-2931.
Documents you need
- One primary ID, as a photocopy: a DMV-issued driver's license, unexpired or expired for not more than five years.
- Alternative primary ID: a DMV-issued learner's/instruction permit, unexpired or expired for not more than five years.
- Alternative primary ID: a DMV-issued photo identification card (child ID cards excluded), unexpired or expired for not more than one year.
- Alternative primary ID: a current photo ID card (school or employment); check cashing cards are not acceptable.
- Alternative primary ID: an unexpired U.S. military ID card of an active duty or retired member; ID cards of military dependents are not acceptable as primary.
- Alternative primary ID: a U.S. passport, unexpired or expired for not more than five years.
- Alternative primary ID: a West Virginia Criminal Justice Agency Offender Information Form or a United States Probation Offender Information Form.
- Instead of one primary ID, two secondary documents. Choices showing your name and current address: utility bill, automobile registration, automobile insurance card, voter's registration card, checking account deposit slip or bank statement, paycheck stub or W-2 form.
- More secondary choices: Social Security card, U.S. Selective Service Card, U.S. military discharge papers (form DD214), health care insurance card, Veterans' Universal Access Identification Card.
- More secondary choices: an unexpired welfare/social services photo identification card issued by a municipality, or an unexpired weapons or gun permit issued by a federal, state or municipal government.
- Proof of relationship, when you order a certificate other than your own; the form says it may be required.
- Proof of legal representation, if you are a legal representative requesting the record.
How to fill out Application for Copy of West Virginia Death Certificate
Enter the name on the certificate
Under the heading for information found on the certificate, print the person's First, Middle and Last name. The form says to print except where a signature is required.
Enter the date and place of death
Write the date of death as Month/Day/Year, then the City, County and State, and mark Male or Female for Sex.
Mark your relationship
Under Requestor's Relationship, check Parent, Guardian or agent, Grandparent, Child of decedent or Spouse. If none fits, check Other (Describe) and describe it.
Sign and print your name
Sign on the line marked Signature (Required) and print your name on Printed Name (Required). The form notes penalties for false statements.
State the reason for the request
Write your reason on the line Reason for request.
Enter copies and payment
On the line starting Enclosed is $, enter the total enclosed and the number of copies. Payment is a check or money order made payable to Vital Registration, not cash.
Print your return address
Under Send copies to, print your address, including City, State and Zip, plus your area code and daytime telephone number and your e-mail address.
Prepare your ID and proof
Photocopy one primary ID or two secondary documents. Add proof of relationship if you order a certificate other than your own, or proof of legal representation if you are a legal representative.
Review and download the completed PDF
Check names, date of death, signature and the total enclosed. Download or print the completed PDF from FillingPDF and assemble the package described under How to submit.
How to submit Application for Copy of West Virginia Death Certificate
The form is submitted by mail to West Virginia Vital Registration with a check or money order. It names no other channel.
- By mail: send the completed form, a photocopy of your ID and any proof of relationship, and your payment to: Vital Registration, Room 165, 350 Capitol Street, Charleston, WV 25301-3701.
- Payment: a fee per copy applies. Send a check or money order made payable to Vital Registration, and do not send cash. Write the total and the number of copies on the form; ask Vital Registration for the current per-copy amount.
- Identification: for mail requests a photocopy of your ID is sufficient. Do not send the original.
- Questions: the Vital Registration information line is (304) 558-2931.
Print your return address in the Send copies to block so the copies reach you. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Sending cash; the form says to send a check or money order and not to send cash.
- Making the check or money order payable to anyone other than Vital Registration.
- Mailing your original ID; for mail requests a photocopy is sufficient and the original should not be sent.
- Enclosing only one secondary document; the form requires two secondary documents when you do not submit a primary one.
- Using an ID outside the stated validity window, such as a driver's license expired more than five years or a DMV photo ID card expired more than one year.
- Submitting a check cashing card or a military dependent's ID card as a primary identity document; neither is accepted.
- Leaving out the signature or the printed name; both are marked (Required) on the form.
- Ordering a certificate other than your own without proof of relationship, or as a legal representative without proof of legal representation.
- Making false statements or misusing the record; the form cites criminal and civil penalties under WV Code §16-5-38.
Frequently asked questions
What is the Application for Copy of West Virginia Death Certificate?
It is the form you send to West Virginia Vital Registration to order copies of a death certificate. It identifies the person on the certificate and the requestor, and states the reason, the number of copies and the payment enclosed.
Who can order a West Virginia death certificate?
The informant listed on the certificate, parents, grandparents, adult children and grandchildren, adult siblings, the spouse, and legal representatives with proof of legal representation. Proof of relationship may also be required. Records at least 50 years old are not restricted to those groups.
What ID do I need to order a West Virginia death certificate?
Photo identification is required for every order. Submit one document from the primary list, such as a DMV-issued driver's license or a U.S. passport, or two documents from the secondary list. A photocopy is enough for mail requests; do not send the original.
Where do I mail the West Virginia death certificate application?
Mail it with a check or money order to Vital Registration, Room 165, 350 Capitol Street, Charleston, WV 25301-3701. The form names no other submission channel. Questions can go to the information line at (304) 558-2931.
How do I pay for copies of a West Virginia death certificate?
A fee per copy applies. Send a check or money order payable to Vital Registration, and do not send cash. Enter the total and the number of copies on the form. For the current per-copy amount, contact Vital Registration at (304) 558-2931.
Can I fill out the West Virginia death certificate application online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is independent of the agency and does not file the form or send copies; you mail the completed form to Vital Registration yourself.
Are West Virginia death records public?
No, not in most cases. The form states that death records are confidential and not open to the general public, except for those that are at least 50 years old. Everyone else must qualify under the list of people entitled to obtain records.
What happens if I give false information on the application?
The form warns that false statements and misuse of vital records result in criminal and civil penalties under WV Code §16-5-38. That is why it requires your signature, your printed name and photo identification with every order.
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