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Death Certificate Request

Deceased Vital Statistics for Death Certificate

Deceased First Name*

Deceased Last Name*

Street

City

State/Province

ZIP/Postcode

Date of Birth

City of Birth

State of Birth

Country of Birth

Date of Death

Place of Death - Location

Place of Death - Name

Place of Death - Street

Place of Death - City

Place of Death - State

Place of Death - County

Full Name of Surviving Spouse

Death Certificate Quantity Requested*

Free Text

First Copy: $14.00

Free Text

Each Additional Copy: $11.00

Informant/Person In Charge Information

Full Name

Relationship to Deceased

Email*

Telephone Number

New Field:

I would like to receive email updates from Baue.

Other Information & Instructions

Please list any other information or instructions you would like us to have

620 Jefferson Street

St. Charles, MO 63301

3950 W Clay Street
St. Charles, MO 63301

311 Wood Street
O'Fallon, MO 63366

4175 Shady Springs Lane
St. Peters, MO 63376