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18030 Foundation Drive, Suite A Noblesville, IN 46060 Phone: (317) 776-8500 Fax: (317) 776-8506 Charles Harris, MD-Health Officer Instructions for Death Certificate Requests via Mail All persons who passed away in Hamilton County after 1882 have a written death certificate on file with the Health Department. These records are legal copies. To obtain a copy of a death certificate or request a genealogical search, please complete the following: 1. Complete Application 2. Cash or Money Orders ONLY – No Personal Checks or Credit Cards a. Fees: $15 each plus applicable Coroner fee of two dollars and fifty cents ($2.50) TOTAL: $17.50 per certificate requested 3. Self-Addressed Stamped Return Envelope For records of deaths outside of Hamilton County please contact the Indiana State Department of Health at www.in.gov/isdh Mail Request to: Hamilton County Health Department 18030 Foundation Drive, Suite A Noblesville, IN 46060 ---PAGE BREAK--- 18030 Foundation Drive, Suite A Noblesville, IN 46060 Phone: (317) 776-8500 Fax: (317) 776-8506 Charles Harris, MD-Health Officer Application for search & certified copy of DEATH RECORD WE HAVE HAMILTON COUNTY DEATHS ONLY!!!! PLEASE COMPLETE ALL ITEMS BELOW In accordance with Indiana Code 16-37-1-7, requests for death certificates must include the information below. A permanent record of this request must be kept on file. FULL NAME AT ARE YOU RELATED TO THE ABOVE PERSON? How? DATE OF PLACE OF DEATH (city) FULL NAME OF FATHER (if known) FULL MAIDEN NAME OF MOTHER (if known) WHY DO YOU WANT THIS RECORD? HOW MANY COPIES DO YOU WANT? No Personal Checks – No Bills Over $20.00 YOUR YOUR NAME (Please Print) PHONE TODAY’S DATE FOR OFFICE USE ONLY: PG. DATE ISSUED BY