Date: Initials: HD02085F REV 06/18 DEATH for a Death ...
PART 2: DEATH CERTIFICATE BEING REQUESTED (First) (Middle) (Last) (Suffix) NAME AT DEATH. AGE AT DEATH DATE OF DEATH (State) (County) (City/borough/township) PLACE OF DEATH. ... to RA-DHBHSRVETDEATH@pa.gov or faxed to 717-724-6931. Order from Pa.’s only authorized online provider. at www.vitalchek.com or by phone at 866-712-8238 (credit cards ... ................
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