Overview
A death record is a vital document that records a death. The Vital Records Office produces a death certificate based on that record. If that record is incorrect, the death certificate will also have incorrect information. Changing a death record will allow you to requested and updated death certificate.
The person who originally gave the information on the death certificate can use this form. Or, someone who has a court order can use it to change the record. After the changes are made, you'll be informed of the changes and have the opportunity to request an updated death certificate.
Additional resources:
How to Edit a Death Certificate
To fill out the request to edit a death record, you will need fill out all five parts of the request form.
- Part 1: Contact information
- Part 2: Information about the death record to be edited
- The person's legal name
- Social security number
- Date of birth
- Date of death
- State file number
- Part 3: Only fill out the information that needs to be changed on the death certificate
- Part 4: Provide evidence of the change you are requesting
- Part 5: Provide a copy of your identification
This form will need to be signed in front of a notary. If you are submitting a certified copy of a court order that authorizes the change to the death record, it doesn't have to be signed in front of a notary.
Mail the completed form to:
Pa. Department of Health
Bureau of Health Statistics and Registries
ATTN: Death Registry
555 Walnut St., 6th Floor
Harrisburg, PA 17101-1934