Request for Certified Copy of Death Certificate
Name on Death Certificate
First Name ___________________________ Middle Name______________________________
Last Name _____________________________________________________________________
Date of Death ___________________________
# of Copies Requested _____________ $ Amount Enclosed __________________
$25 for 1
st
copy
$ 5 for each additional copy of the same record
Requester’s Information
Full Name ______________________________________________
Relationship to Registrant _______________________________ Phone # __________________
Include:
o Legible Copy of Valid Photo ID
o Documents to prove relationship to Registrant, if applicable.
(If no proof is provided, the Social Security Number will be redacted.)
o Money order (No personal checks accepted)
o Self-Addressed Stamped Envelope
Mail the Request to:
Camden County Probate Court
PO Box 818
Woodbine, GA 31569
