The City of Cambridge
Office of the City Clerk
795 Massachusetts Avenue
Cambridge, MA 02139
617-349-4260
Mon. 8:30 am to 8:00 pm
Tues., Wed. & Thur.
8:30 am to 5:00 pm
Fri. 8:30 to Noon
MAIL IN REQUEST FORM FOR
DEATHS OCCURING IN CAMBRIDGE OR
RESIDENTS OF CAMBRIDGE AT THE TIME OF DEATH
YOUR REQUEST SHOULD INCLUDE:
1. The completed request form
2. A self-addressed, stamped envelope
3. Payment of $10.00 per certified copy - check or money order payable to the
City of Cambridge
Please allow one week for mail requests to be filled
PLEASE TYPE OR PRINT
FULL NAME OF
PERSON ON RECORD
Last
DATE OF DEATH
APPLICANT'S NAME
MAILING ADDRESS
DAYTIME PHONE E-MAIL
RELATIONSHIP TO PERSON WHOSE
CERTIFICATE IS REQUESTED
First Middle
LastMiddleFirst
Street City State (Abbr.) ZIP code
Please Note: If you need expedited service and have a major credit card you may also contact the Division of Vital Statistics at (617) 740-2600 or 740-2606.
They have all Massachusetts records for the years 1911 through the present. Call them for fee information, as their fees are different than this office.
Signature of Applicant Date
NUMBER OF
CERTIFIED COPIES
Print Form
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