Official Arkansas Death Certificate Application Template in PDF

Detailed Instructions for Using Arkansas Death Certificate Application

Filling out the Arkansas Death Certificate Application form is an essential step for individuals who need to obtain a certified copy of a death certificate in Arkansas. This process ensures that the necessary documentation is provided for various legal and personal matters. Whether for settling an estate, claiming benefits, or keeping a record, it's important to complete the form accurately and submit it with the correct fee. Here are the steps to help guide you through the application process.

1. Start by entering the full name of the deceased, including their first name, middle name, and last name.
2. Fill in the date of death with the month, day, and year.
3. Indicate the age of the deceased at the time of death and their sex.
4. Provide the place where death occurred, including the city or town, county, and state. If the exact place of death is unknown, list the last place of residence.
5. Enter the name of the funeral home involved in the deceased's arrangements.
6. Provide the address of the funeral home.
7. Include the name and address of the attending certifier who declared the death.
8. If the deceased was an infant and was stillborn, mark the appropriate checkbox for "Yes" or "No".
9. Specify your relationship to the deceased and your reason for requesting the death certificate.
10. Sign the application, including your signature and telephone number at the bottom.
11. Indicate the number of copies you are requesting and calculate the total amount of money enclosed. The first certified copy costs $10.00, and each additional copy costs $8.00. Remember, the fee must accompany the application.
12. Make a check or money order payable to the Arkansas Department of Health. Remember, do not send cash.
13. Mail the completed application, a copy of your photo ID, and the payment to: Arkansas Department of Health Vital Records, Slot 44, 4815 West Markham, Little Rock, AR 72205.

After submitting your application, please allow 4-6 weeks for processing. It's important to ensure that all information provided on the form is accurate and complete to avoid any delays in receiving the death certificate. If you need the certificate sooner, consider using the expedited service options available through internet or telephone orders, which also require credit card payment for the certificate fee and an additional shipping fee for overnight returns.

What are the fees for obtaining a death certificate in Arkansas?

The initial fee for requesting a certified copy of a death certificate is $10.00. If additional copies are needed, each copy costs $8.00. These fees are payable to the Arkansas Department of Health and must accompany the application. It's important to note that a $10.00 fee is retained to cover search charges if no record is found.

Can I order a death certificate for a death that occurred outside Arkansas?

No, the Arkansas Department of Health’s Office of Vital Records only records and provides certificates for deaths that occurred within the state of Arkansas. For deaths that occurred outside Arkansas, you’ll need to contact the appropriate state’s office of vital records.

Are there death records available before February 1, 1914?

Yes, but there are only a limited number of death records filed in this office for deaths that occurred before February 1, 1914. If you’re seeking a death certificate from this time period, additional research and possibly contacting local archives may be necessary.

What forms of payment are accepted for the death certificate application?

For mail orders, the Arkansas Department of Health accepts checks or money orders. Make sure these are payable to the Arkansas Department of Health. Cash is not accepted for mail orders to ensure the security of your payment.

How long does it take to process a death certificate application in Arkansas?

The processing time for a death certificate application is typically 4-6 weeks. This timeframe may vary depending on the workload of the Vital Records office and the details provided in the application.

What identification is required when requesting a death certificate?

All requests for death certificates require submission of a copy of your photo ID. This requirement is in place to protect the privacy and ensure the security of personal information.

Can I order an Arkansas death certificate online or by phone?

Yes, you have the option to order death certificates online through www.vitalchek.com or by telephone at (866) 209-9482. Both methods require payment through a major credit card (Visa, Master Card, Discover, or American Express). Additional fees for service and optional overnight shipping may apply.

What are the penalties for providing false information on a death certificate application?

Providing false information on a death certificate application is a serious offense. Anyone found willfully and knowingly making any false statement on an application is subject to a fine of up to ten thousand dollars ($10,000), imprisonment for up to five (5) years, or both, as per Arkansas Statutes 20-18-105.

Filling out an Arkansas Death Certificate Application can be a complex process, and understanding common mistakes can help avoid unnecessary delays or issues. Here are six key errors often made:

1. Failing to include all possible names the deceased may have been registered under, including maiden names, aliases, or name changes. Every possible name variation should be listed to ensure the search for the death certificate is thorough.

2. Not specifying all possible dates of death. If the exact date of death is unknown, listing a range of dates can help in locating the right record.

3. Leaving the fee section blank or sending the incorrect amount. Remember, the first certified copy costs $10.00, and each additional copy is $8.00. Sending the right amount the first time can prevent delays.

4. Omitting a copy of the requester's photo ID. The application process requires a form of photo identification to process the request. Not including this can result in an immediate rejection.

5. Not clearly indicating the reason for the request or the relationship to the deceased. This information is crucial for processing your application and ensuring the certificate is released to the right individual.

6. Attempting to order for deaths that occurred outside of Arkansas. The form clearly states that only Arkansas deaths are recorded in this office, so attempting to request a certificate for a death that occurred elsewhere is a mistake.

Avoiding these common errors can smooth the process of obtaining a death certificate from the Arkansas Department of Health. As with any official request, attention to detail and following the instructions closely can help you efficiently achieve your goal.

When managing the delicate matter of accessing vital records, particularly following the loss of a loved one in Arkansas, the Death Certificate Application is crucial. Alongside this application, individuals often find themselves requiring additional forms and documents to complete their affairs comprehensively. Understanding these documents and their purposes can help streamline this challenging process.

• Affidavit for Correction of a Death Record: Used when there is a need to correct information on an already issued death certificate. This form must be submitted with supporting documentation for the requested change.
• Request for Verification of Death Fact: Individuals who may not need an official death certificate but require confirmation of death can use this form. It verifies the fact of death without providing the full details contained in the official death certificate.
• Authorization Release Form: This document is necessary when a person needs to authorize the release of the death certificate to someone other than themselves, such as a family member or legal representative.
• Certificate of Burial Right Transfer: Relevant for situations where the deceased owned a burial plot or crypt, and the right of use needs to be transferred to another individual or returned to the cemetery.
• Claim for Funeral Benefits: If the deceased was entitled to funeral benefits through their insurance or an employment benefit program, this form would be used to claim those benefits.
• Social Security Administration (SSA) Notification of Death: Required to inform the SSA of a person's death to stop payments and possibly qualify for death benefits.
• Life Insurance Claim Forms: To claim benefits from a life insurance policy, beneficiaries need to submit a claim form along with a certified copy of the death certificate to the insurance company.

Navigating the aftermath of a loss is inherently challenging, compounded by the administrative tasks that follow. Armed with the correct forms and a clear understanding of their functions, individuals can undertake these tasks with confidence, ensuring that all affairs are settled respectfully and in accordance with legal requirements. It's advisable to reach out to professionals or the respective departments for guidance and verification of any specific requirements or procedures.

The Arkansas Death Certificate Application form shares similarities with the Birth Certificate Application form. Both are vital records applications used to request official copies of life events. Each form requires basic information about the person whose record is being requested, such as full name, dates, and places of significant events (death or birth). Applicants must also state their relationship to the individual and the reason for the request. Additionally, both forms include a section for payment details and a warning about the legal consequences of providing false information, reflecting their roles in maintaining accurate and legal records of life events.

Another document resembling the Arkansas Death Certificate Application form is the Marriage Certificate Application. Similar to the death certificate application, this form requires specific details about the event, such as the names of the individuals, the date, and location of the marriage. Applicants need to provide a reason for the request and their relationship to the individuals named on the certificate. Payment instructions are also detailed, requiring fees for processing. Both documents are essential for legal proof of life events and require validation through photo identification for processing.

The Divorce Decree Request form also parallels the Arkansas Death Certificate Application form in several aspects. This form is utilized to obtain official documentation of a divorce, requiring the full names of both parties involved, the date, and the location of the divorce. Similar to the death certificate application, it necessitates details about the requester’s relationship to the individuals and the purpose for the request. Fees for processing and obtaining certified copies are outlined, and the importance of including a photo ID for verification purposes is emphasized in both forms.

A less obvious comparison can be made with the Passport Application form. While this document is used for a different purpose, it also gathers personal details, requires proof of identity, and verifies the applicant's citizenship status – akin to how vital records applications verify life events. Both sets of forms include warnings about the consequences of falsifying information, stressing the importance of accuracy and legality. Payment details and processing times are outlined, reflecting the procedural nature of government-issued documents.

Lastly, the Arkansas Death Certificate Application form is similar to the Request for Change of Name form. Although one is for recording a death and the other for changing a legal name, both require detailed personal information, a valid reason for the request, and the inclusion of legal documentation (e.g., a photo ID). They both necessitate payment for processing and highlight the legal ramifications of submitting false information. Each form serves to officially alter or record significant life details in official government records.

When filling out the Arkansas Death Certificate Application form, it's important to follow a set of dos and don'ts to ensure the process goes smoothly and to avoid any potential errors or delays in obtaining the needed document. Here is a helpful list of things you should and shouldn't do:

• Do ensure that all information provided on the application is accurate and complete. Double-check the full name of the deceased, dates of death, and other crucial details before submitting.
• Do type or print legibly in black ink. This ensures that all information is easily readable and reduces the risk of errors in the death certificate.
• Do provide a copy of your photo ID with the application. This step is essential for verifying your identity and relationship to the deceased.
• Do list all possible dates of death and names under which the certificate may be registered if you are not certain of the exact details. This increases the chances of locating the correct record.
• Don't send cash through the mail with your application. Instead, send a check or money order payable to the Arkansas Department of Health to minimize risks.
• Don't underestimate the processing time. Allow 4-6 weeks for the processing of your application and plan accordingly.
• Don't forget to sign the application and include your telephone number. Your signature and contact information are required for the application to be processed.
• Don't make false statements on the application. Remember, providing false information on this document can lead to significant fines or even imprisonment.

Following these guidelines can help streamline the process of obtaining a death certificate from the Arkansas Department of Health. Remember, this document is an important legal record, and taking care to fill out the application correctly is crucial.