Application for Death Certificate

Sample application for death certificate from hospital, clinic, doctor, or medical center. This application letter for death certificate is to be used to ask for death certificate from govt official authorities for closing NIC, Bank Accounts, Property Division, Business Division, or transfer by the son, daughter, brother, wife, or relatives etc.

Application Letter to Hospital for Death Certificate

Medical Superintendent
Adirondack Medical Center
29 Church St, Lake Placid,
NY 12946, United States

Subject: Request Letter for Death Certificate

Dear Concern,
I am writing for death certificate of my younger brother (James Albert, NIC 5570847, S/O, Albert, DOB 11 Jan 1982) who has been passed away in this hospital yesterday after severe injuries during a road accident. We moved our bother to this hospital from local clinic for better treatment but he could not recovered due to head injuries. I am attaching hospital slips from clinic as well as of your hospital for reference. Furthermore you can recheck the hospital record. We need it urgently for closing his ATM cards, Bank Accounts, Licences, Mobile Numbers, and Passport with Visas etc.
I request you to please issue his death certificate urgently to avoid any other incident.

Thanking You,


Email Letter Asking for Death Certificate

The commissioner,

Social Services Department.

San Francisco. USA.

Subject: Application for death certificate.

Dear Sir,

With due respect, it is to submit that my father Mr. Roger Philips resident of San Francisco USA died because of a sudden heart failure on Monday i.e. 25-02-(Date). His funeral services were conducted on Tuesday 26-02-(Date).

I am his legitimate heir, and I request you to grant me his death certificate which is a legal requirement to carry on his business, and to sort out some legal issues regarding his property. All the necessary documents, and hospital certificates are attached with this application.

Kindly, grant my request as early as possible, and enable me to submit the required document. I shall be highly grateful.


Peter Philips.

San Francisco. USA

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