County Clerk's Office - Vital Records

Death must have occurred in Ottawa County. Use this form to order a death record from 1867 to 1945. The document will be mailed to you. For death records 1946 to present, please use the online death record search.

Death Certificate Request

Please provide the following information pertaining to the deceased. All fields except for parent information must be completed.

*Last Name of deceased at death:

*First & Middle Names:

Mother's Maiden Name (optional):

Mother's First & Middle Names (optional):

Father's Last Name (optional):

Father's First & Middle Names (optional):

*Place of Death:

*Date of Death:

Month of Death:
Day of Death:
Year of Death:

*Date is:

Exact Approximate (a maximum of 10 years will be searched)

*Number of copies:

*Purpose of Document:

Foreign Adoption Passport Social Security Other: Other Purpose:

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