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GENEALOGY RESEARCH REQUEST FORM - DEATH CERTIFICATES CITY OF LEWISTON, MAINE Use one form per search request Search fee is $5.00 per record search Full name of person on record: Include maiden name for married females, if known Date of death (if specific date unknown, list approximate timeframe): Place of death: Death must have occurred in Lewiston or person must have been a resident of Lewiston at the time of death and death must have occurred within the State of Maine Full name of father: Full maiden name of mother: Full name of spouse, if married: Other pertinent information that might help with search (children’s names, Relationship/connection to the deceased: Name of *person requesting search: Address of person requesting search: Email Signature: Daytime phone number: MUST INCLUDE A PHOTOCOPY OF A GOVERNMENT ISSUED PHOTO I.D. * Person requesting record must be a direct descendant and prove lineage or provide us with a copy of their State of Maine Genealogists I.D. Card. All death records over 25 years old are open to the public and no identification is required. Be sure to enclose a self addressed stamped envelope with each search request. Please allow about three to four weeks for processing the search request. Most requests can be processed within one week, depending upon the time of year. The fee is $5.00 per record searched. Please make check or money order payable to “City of Lewiston”. Mailing address: Lewiston City Clerk’s Office, 27 Pine Street, Lewiston, ME 04240 Please note effective July 1, 2010 a 2.5% processing fee will be added to all debit & credit card purchases A $1.00 minimum fee will be charged for all debit and credit card transactions Fax Number: (207) 777-4621 If you are faxing your request please include the following: Signature of cardholder Name as it appears on the credit card Credit Card Date _________Billing Zip