Online Death Certificate Request
Step 1, Please Enter All Information

This is an official online vital record request.

Please note the following:

    • The fee payment will be paid through Permitium Payments. The charge will show on your credit card statement as 'PermVitalRecs'

 

Attention:


The State Office is requiring that all applicants upload a form of identification when submitting their application. Click on the button below for information on the forms of identification acceptable.

  • Failure to provide valid identification, will result in denial of the order. 
  • Failure to provide supporting documentation, will result in denial of the order. 

 

Click here for list of forms of identification


Click here for information regarding qualified applicants


Click here for FAQs on applying for a Birth/Death Certificate

Please Enter The Full Name Of Deceased:


Parent Names of the Deceased:


Please Enter The Location Of Death:


Funeral Home


Please Enter The Requestor's Name:



Requestor's Current Residence Address: (this may be different than the mailing address)


Requestor's Current Mailing Address: (if different from residence address)


Requestor's Contact Telephone Numbers: (###-###-####)


Requestor's Driver's License: (or other State Issued ID)


Requestor's Email:


Please attach your photo identification

  I will mail these documents.  

We can only accept valid government issued identification (e.g. current driver's license, military ID, etc.).  "SELFIES" ARE NOT VALID FORMS OF IDENTIFICATION AND WILL NOT BE ACCEPTED.

Please upload the FRONT and BACK of the ID.  

Please note: Failure to upload the FRONT and BACK of a valid ID at this time will result in delays while processing your request.
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Reason for Request:


Select Delivery Method:


Please select the document delivery method



The individual listed on the Death Certificate is:


Select The Information Type(s) Requested:


Total Fee:

$0

AUTHORIZATION NOTIFICATION:
My initials below constitute an electronic signature and authorizes the City of Bryan Vital Statistics to release information and / or my vital record and confirms I have completed all sections accurately and truthfully, including information verifying my identity. I understand that the recipient of the record(s) will use the indicated documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other party or agency without my expressed written consent. I understand the penalty for knowingly making false statements on this form is a third degree felony and may be punishable with up to 2 - 10 years in prison and a fine of up to $10,000 Health and Safety Code of Texas, Chapter 195, Sec. 195.003.
 

In the event that your certificate cannot be located, you will receive notification from our office and a full refund will be issued to you.

 
I have enclosed the correct fees and understand that they are refundable if no record is found and the order can't be processed.  I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.
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