Death Report Form PDF

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Death Report Form

This is a death Report form issued by the Register Office for obtaining the Death Certificate in India. In this report, an application form in the format along with a declaration needs to be furnished at the concerned Registrar office. In India, every death has to be registered with the concerned State Government as per the rules of Registration of Birth & Death Act, 1969.

Following details are provided for the Death Report

  • Age of the deceased
  • Gender
  • Name of the father or husband
  • Details regarding the place of death and date of death
  • The purpose of applying death certificate
  • Information about the relation of the applicant with the deceased

Documents Required

Death Report Form PDF - 2nd Page
Page No. 2 of Death Report Form PDF

Following documents are necessary required:

  • Declaration by a close relative or family member in the prescribed format
  • Application Form
  • Address Proof of deceased (Voter ID card, electricity, gas, water, telephone bill, passport, valid ration card or Aadhaar card, name of the deceased)
  • If the registration is not done within 21 days from its occurrence an affidavit stating the reason for the delay in registration to be submitted to the concerned Registrar of that area.

Download the Death Report Form in PDF format using the link given below.


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