USR

State of Pennsylvania — Vital Records

Death Certificate Order

Order No.

Pennsylvania Death Certificate Order Form

(One page order form, 2-5 minutes to complete.)

Identity verification is required before your order can be submitted to the issuing agency.
After submitting this form, you will receive a secure link to upload your photo ID and confirm your identity (NOTE: if you don't have time for this step after submitting this form, you can use the link we email to you, to come back and complete your ID verification later).

Death Certificate Information

Certificate Type *

Country of Death *

State/Territory Where Death Certificate Was Issued *

County Death Certificate Was Issued *

City / Town Where Death Certificate Was Issued *

Enter the city or town where the death occurred. If unsure, choose the city where the hospital or facility was located.

Why do you need this death certificate? *

Select the closest option so we can prepare the correct certificate type.

Person on this Death Certificate

Newly registered deaths can take a few weeks to reach the issuing office.

First Name *

Middle Name

Last Name *

Date of Death *

I don't know the exact date

Date of Birth (if known)

Sex on Record (if known)

Has the Name on the Record Ever Been Different?

NoYes

Anything else that helps locate the record (optional)

The agency searches its index with these details. Leave anything blank if you don't know it — it won't hold up your order.

Social Security Number of the Deceased

Used only to help the agency find the right record.

Mother / Parent of the Deceased

Spouse / Domestic Partner of the Deceased

About You, The Death Certificate Requestor

Your relationship to the person on the certificate *

Order Processing Service Selection

Your Service

This service level includes preparation, payment handling, and submission to the state or county office.

Number of Certified Copies *

Most customers order 2–3 certified copies for different agencies.

Ordering additional copies later typically requires submitting a new order to the state.

Additional certified copies are often required for:

Passport applications
REAL ID verification
School or daycare enrollment
Social Security records
Marriage license applications
Estate or legal matters

You'll review exact pricing in your Order Summary.

Processing Speed *

Issuance time is set by the issuing agency. Choosing a faster service means faster preparation, filing and routing to the issuing agency.

Shipping Address (where we will mail this death certificate)

Deliver To

Recipient Name *

The certificate must be mailed to you, the requestor.

Shipping Address

Address Line 1 *

Address Line 2

City *

State/Province *

ZIP/Postal Code *

Country *

Contact Information

Phone *

Email *

Your ID verification link and all order updates go to this address.

Confirm Email *

Payment Information

We accept

Cardholder Name *

Card Number *

Expiry *

CVC *

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Visa and Mastercard accepted.

Order Summary

Your Order

Certificate Type:death Certificate

State:pennsylvania

Order Processing/Services Fee (0 × $140)$0.00

Agency FeeTBD

Agency fee calculated before submission.

Processing SpeedTBD

TotalTBD on form completion

Verify Order

Please review the statements below and sign to certify your order.

Pennsylvania Death Certificate Order

Order No.—

I certify that the information provided in this application is true and accurate to the best of my knowledge. I confirm that I am authorized to order this record under applicable law, authorize US Records to prepare and submit this application on my behalf to the appropriate issuing agency, and understand that agency fees and processing times are determined by the issuing authority. I have read and agree to the and Terms of Service. *

Electronic Signature (Type Your Full Legal Name) *

Typing your name serves as your electronic signature and legal certification of the information provided.

Signed electronically upon submission.

Identity verification is required before your order can be submitted to the issuing agency. After submitting this form, you will receive a secure link to upload your photo ID and confirm your identity.

NOTE: If you need to do this ID verification step at another time, just submit this order and use the link we send you through email, to come back and complete this step.

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Order total

$0.00