Death Certificate Request Form (VS-39DST)
Official state formForm VS-39DSTFree downloadLast verified November 5, 2026
The Connecticut Department of Public Health application to order a certified copy of a Connecticut death certificate by mail.
Who can use this form
- Any person 18 or older, or a genealogist
- Only the informant named on the certificate, the surviving spouse or next of kin can get a copy showing the Social Security number, with proof of identity and relationship
- Long form copies cover deaths from July 1, 1897; short form copies cover deaths from January 1, 2021
- The spouse, child or parent of a veteran can get one free copy, with photo ID and proof of relationship
What to send with it
- This two-page request form, signed
- Proof of identity and relationship, if you want the Social Security number on the copy or a free veteran copy
- A money order, business check or cashier's check payable to 'Treasurer, State of CT' (no personal checks or cash)
Where to send it
- Mail to
- State of Connecticut Department of Public Health: Office of Vital Records Attn: Customer Services 410 Capitol Ave, MS # 11VRS Hartford, CT 06134-0308
- State fee
- $20 per certified copy
- Typical processing
- Up to 12 weeks at the State Vital Records Office; town offices are generally faster
- Source
- Official government page