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© 2014 USVitalRecords.org

ONLINE SERVICE INFORMATION

Our online service is open to the legal profession and general public to obtain original certified copies of state vital records. Vital certificates and forms may be ordered from the relevant government agency for free or a lesser cost. No visit to the government agency is required through Vital Certificate Processing Services' online ordering service. The online processing fee is for the cost of providing a secure online ordering service, expert assistance and thorough review of all pertinent information to ensure compliance with government rules and regulations.

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Louisiana Death Certificate Order Form


Death certificates can be ordered from this website if the death occurred within the State of Louisiana within the last 50 years.


ID Requirements must be met before you receive your death certificate. You will receive an email with instructions on how to send your ID within one week of submitting this application.

INFORMATION ABOUT THE SUBJECT OF THE CERTIFICATE

INFORMATION ABOUT THE REQUESTOR


IMPORTANT!: The requestor is the person ordering the certificate, not the person named on the certificate. The name of the credit card holder must be the same as the requestor.

Name of Deceased: The name of the descendant at the time of death.

Date of Birth & Social Security Number of the Requestor: This is an additional safeguard to protect your identity and the security of the requested certificate.

Delivery Address: If certificate is delivered by UPS shipping, it must be signed for at this address. Certificates delivered by UPS cannot be sent to a P.O. Box.

ORDER INFORMATION

*UPS to Alaska, Hawaii or Puerto Rico is $25.50. UPS to all international locations is $37.00.

CERTIFIED COPY OF LOUISIANA DEATH CERTIFICATE

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Date of Death: Death certificates can be ordered through this website if the death occurred in the State of Louisiana in the last 50 years.

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Social Security Number (SSN) of Deceased: Please enter the Social Security Number of the deceased.

Telephone & Email Address of the Requestor: ID requirements and other important information will be emailed to you. An incorrect email will result in delays.

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Credit Card Security Code.

TOTAL FEE WILL APPEAR AS 2 SEPARATE CHARGES ON YOUR CREDIT CARD. U.S. VITAL RECORDS or U.S. VITAL CERTIFICATES $52.87 (upon receipt of your application) & VCN LOUISIANA $39.95 for UPS Delivery OR $20.45 for Regular Mail (AFTER ID requirements are met).

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CREDIT CARD INFORMATION - Cardholder Must be the Person Making the Request


VERIFY REQUEST


Enter your full name in the box below. Entering your name constitutes a signature and an agreement that you have read and agree to all the provisions contained below. It additionally affirms that all information provided on this order form is complete and accurate and that you are a person authorized to obtain a Louisiana Vital Certificate as indicated by your answer to Relationship to Subject.


Type full name to represent your signature and acknowledge that the terms below have been accepted.

1. I understand ID requirements must be met before you receive your requested vital certificate. You will receive an email within one week of submitting this application with instructions on how to send a copy of your government issued picture ID. The ID must be of the person requesting the vital certificate.


2. I agree and understand that the total fee is broken down into 2 payments. The initial fee of $52.87 per certificate will appear on your credit card as ‘U.S. Vital Records’ or ‘U.S. Vital Certificates’. The second fee will appear as ‘VCN Louisiana’.


3. I have read and agree to the Terms of Service.

Retype Email Address

First Name

Middle Name

Current Last Name

Month of Birth

Day of Birth

Year of Birth

Social Security Number

Reason for Request

Relationship to Deceased

First Name

Middle Name

Current Last Name

Maiden Last Name

Suffix

Gender

City Death Occurred In

Parish of Death

Month of Death

Day of Death

Year of Death

Delivery Address

Delivery Address Continued

Town/City

State/Province

Country

ZIP/Postal Code

Select Number of Copies

Select Delivery Method

Email Address

Credit Card Type

Credit Card Number

Credit Card Security Code

Full Name of Cardholder

Cardholder Email

Credit Card Expiry Date

Daytime Telephone

Alternate Telephone

SSN of Deceased