Death Application

WISCONSIN DEATH CERTIFICATE APPLICATION

PDF form version

Please check with local county or www.wrdaonline.org\vitalrecord as some counties require money order.

PENALTIES:  Any person who willfully and knowingly makes false application for a death certificate is guilty of a Class I felony  [a fine of not more than

                      $10,000 or imprisonment of not more than three years and six months or both per Chapter 69.24 (1), Wisconsin Statutes].

A CERTIFIED COPY of a death certificate issued by our office will have a raised seal, will show the signature of the Registrar, and will be printed on security paper.  A certified copy may be required to settle an estate or to claim insurance benefits.

State law restricts who may obtain a certified copy of a death certificate.  A certified copy can only be issued to the following people:

• an immediate family member (spouse, child, parent, sibling, or grandparent of the decedent)
• a person authorized in writing by one of the above.  (The written authorization must accompany the request and the relationship of the authorizing party to the decedent must be clearly explained.), or
• a person who can demonstrate that the death certificate is required to protect a personal or property right.

If you meet one of the above criteria, you may receive a certified copy of the death certificate. 

• For Pre-2003 death certificates, a certified copy will automatically include cause of death and disposition information.
• For 2003 and later death certificates, you must specify if you want a "Fact of Death" certificate (which does not include cause of death and disposition information) or if you require the "Extended Fact of Death" certificate (which includes cause of death and disposition information).

A NON-CERTIFIED COPY of a death certificate is available to anyone who applies.  However, a non-certified copy will not be acceptable for legal purposes, such as claiming insurance benefits. 

• For Pre-2003 death certificates, a non-certified copy of a death certificate will contain the same information as a certified copy.
• For 2003 and later death certificates, only persons named in the above list and direct descendants of the decedent may have access to information in the "Extended Fact of Death" certificate (which includes cause of death and disposition information).