Florida Affidavit to Release Cause of Death Information (DH 1959)
Official state formOther requestsForm DH 1959Free downloadLast verified November 10, 2026
Notarized affidavit in which a person entitled to a Florida death certificate with cause of death lets another named person obtain it. It is good for one use. It is sent with death application DH 727 to the Bureau of Vital Statistics.
Who can use this form
- The surviving spouse listed on the death certificate
- A parent listed on the death certificate
- A child, grandchild or sibling of the decedent, 18 or older
- The legal representative of one of these people (documentation required)
What to send with it
- Notarized affidavit
- Application DH 727 completed by the person who will receive the certificate
- Copy of valid photo ID of both the person giving permission and the person receiving the certificate
Where to send it
- Mail to
- FLORIDA DEPARTMENT OF HEALTH BUREAU OF VITAL STATISTICS ATTN: VITAL RECORDS SECTION P.O. BOX 210 JACKSONVILLE, FL 32231-0042
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- 01/2022
- Source
- Official government page