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Note: For on-line death certificate requests, please go to salem.com/paybills. Scroll down and you’ll find a link to ordering certified long-form copies of death certificates which will be mailed to the address provided. CITY OF SALEM, MA MAIL-IN DEATH RECORD REQUEST The City of Salem only issues certified long-form copies of death certificates of individuals who passed in Salem, Massachusetts or resided in Salem at the time of their death. If you are not certain if this record is on file with the City, please call the City Clerk’s Office at [PHONE REDACTED]. Each Certified Copy Requested: $10.00 No. of Copies Requested:_______ Name of Decedent: Date of Death: Place of Death: Place of Residence: Daytime Phone Number: E-mail Address: Please Send in the Following with Your Request Payment Please enclosed a check or money order made payable to the City of Salem. Each copy requested is $10. Self-Addressed Stamped Envelope Please enclose a self-addressed stamped envelope with your request. This will speed up the arrival of the requested record(s). For URGENT REQUESTS If the record requested is needed urgently we recommend that you send this request (including payment and ID-if needed) by overnight mail and enclose a pre-paid, self-addressed overnight envelope. We also suggest that you call our office to let us know of the urgent request. Genealogy Requests We recommend that you call our office first to confirm whether we have the record on file. Please have the information on hand, such as decedent’s name, date of death, and place of death/place of residence before calling the City Clerk’s Office at [PHONE REDACTED], Ext. 41200 for assistance.