Government Agency Request

Note: All death certificates issued to any government agencies or entities shall be either printed or stamped “For Government Use Only” across the face of the certificate, including those charged a fee.

A governmental agency processing a financial claim, a governmental benefit application, or another form of compensation on behalf of a deceased individual’s estate or having another official purpose for a noncertified copy of the deceased individual’s certificate of death registration may request a noncertified copy of the deceased individual’s certificate of death registration by submitting to the State Registrar or a local registrar:

  • A completed, signed application or a letter of request on the governmental agency’s letterhead, that includes the following:
    • The governmental agency’s name and address
    • Contact information for the governmental agency (telephone number or an e-mail address)
    • The name in the deceased individual’s registered death record
    • The date of birth of the deceased individual
    • The date of death of the deceased individual
    • If known, the:
      • Sex of the deceased individual
      • State file number on the death certificate
      • Town/city of the deceased individual’s death
      • County of the deceased individual’s death
      • Place of the deceased individual’s death
      • Funeral establishment or person responsible for the final disposition of the deceased individual’s human remains
      • Deceased individual’s Social Security Number
    • A description of the:
      • Action the governmental agency is taking on behalf of the deceased individual or the deceased individual’s estate, or
      • Official purpose for which the governmental agency needs a certificate of the individual’s death registration
    • The reason the governmental agency is requesting a noncertified copy of the individual’s certificate of death registration, and
    • The dated signature of the governmental agency’s designee, accompanied by:
  • A copy of the designee’s identification badge from the governmental agency verifying the designee is an employee of the governmental agency
  • The governmental agency submits appropriate fee(s), unless the governmental agency is an exempt agency.

Government Agency Fee Exemption

Effective July 1, 2009, The Bureau of Vital Records will no longer provide free copies (certified or noncertified) to non-Arizona State government agencies. A fee shall not be collected for requests submitted by a state government agency (i.e. Department of Economic Security, etc.), however, request(s) received from a county, federal, or foreign government shall be charged the fee required by Arizona Administrative Code (A.A.C) R9-19-105.

An Agency is defined in Arizona Revised Statutes (A.R.S.) § 41-1001 as “any board, commission, department, officer or other administrative unit of this state, including the agency head and one or more members of the agency head or agency employees or other persons directly or indirectly purporting to act on behalf or under the authority of the agency head, whether created under the Constitution of Arizona or by enactment of the legislature. Agency does not include the legislature, the courts or the governor. Agency does not include a political subdivision of this state or any of the administrative units of a political subdivision, but does include any board, commission, department, officer or other administrative unit created or appointed by joint or concerted action of an agency and one or more political subdivisions of this state or any of their units. To the extent an administrative unit purports to exercise authority subject to this chapter, an administrative unit otherwise qualifying as an agency must be treated as a separate agency even if the administrative unit is located within or subordinate to another agency.”

This list of governmental agencies provides examples of Arizona state government agencies, which are exempt from paying the fee(s) and non-Arizona state government agencies, which would be required to pay the fee(s). You may also refer to the State of Arizona’s website for an agency directory of Arizona state government agencies.

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1. Funeral Director or Funeral Director’s Designee
2. Spouse
3. Parents
4. Grandparent
5. Adult Child
6. Grandchild
7. Brother or Sister
8. A Person Designated in a Power of Attorney
9. A Person Responsible for Final Disposition (Other than a Funeral Director)
10. A Person Named as the Executor or Beneficiary of the Deceased Individual's Estate
11. A Beneficiary of the Deceased Individual's Life Insurance Policy
12. A Person Named in a Court Order
13. A Person Authorized by an Eligible Person
14. An Insurance Company/Financial Institution
15. A Hospital or Healthcare Institution
16. A Person with a Court Order Having a Claim Against the Deceased Individual's Estate
17. An Attorney Representing a Person Eligible to Receive a Certified Copy
18. Consulate of a Foreign Government Request
19. Government Agency Request
20. Noncertified Copy: Genealogical Research
21. Noncertified Copy: Government Agency Request