Michigan Death Record Verification Request (DCH-0569-DX-VER)
Official state formRecord search and verificationForm DCH-0569-DX-VERFree downloadLast verified November 10, 2026
Request for the MDHHS Vital Records office to verify the name, date of death, place of death, and filing date of a Michigan death record. No copy is issued. The form comes back stamped yes or no.
Who can use this form
- The form prints no eligibility limit. It asks for the applicant's name and, if any, the agency name.
- The applicant must sign the request by hand in ink.
What to send with it
- The completed request, signed by hand in ink.
- The facts to verify: the decedent's name, the date of death, and the county of death. They must match the record exactly.
- The filing date, only if you have a copy of the record.
- By mail: a check or money order in U.S. funds payable to the "State of Michigan".
- For expedited service, add the expedited fee and address the envelope to "Vital Records RUSH" at the same P.O. box.
Where to send it
- Mail to
- Vital Records Requests P.O. Box 30721 Lansing MI 48909
- State fee
- $18 per verification search (non-refundable); $12 extra for expedited in-office processing.
- Typical processing
- Mailed requests: about 3 weeks of in-office processing (regular) or about 2 weeks (expedited). In-person requests: 1 to 2 hours.
- Form revision
- Rev. 6-23
- Source
- Official government page