Death Certificate Application

WAYNE COUNTY CLERK Print Clearly

FULL NAME OF DECEASED [First, Middle, Last]
DATE OF DEATH [Month, Day,Year]			CITY OF DEATH *excluding Detroit - Deaths taking place within the City Limits of Detroit are recorded by the :: city of detroit health dept. ::
	Applicant's Name
	Address
	City, State, Zip
	Phone [Area Code + Number]
	Applicant's Signature [Name as it is now]  Date

Please send the following: _____ FIRST CERTIFIED COPY $22.00 _____ Additional certified copies [each] $7.00 [same record] _____ Record Search [each] $3.00 [same record] _____ TOTAL COST
Make money order, cashier's check, or certified check [no personal checks] payable to :
	Wayne County Clerk c/o Birth and Death Records Division 201 Coleman A. Young Municipal Cntr Detroit, MI 48226

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Office Locations

Cathy M. Garrett
Clerk of Wayne County

Coleman A. Young Municipal Center
2 Woodward Avenue
2nd floor, Room 201
Detroit, MI 48226

(313) 224-6262
(313) 224-6771

Monday - Friday
8:00 am- 4:30 pm