Missouri Death Certificate Application (Form MO 580-0641) (MO 580-0641)
Official state formForm MO 580-0641Free downloadLast verified November 9, 2026
Form MO 580-0641 is the combined birth and death application to order a certified copy of a Missouri death certificate. It is filed with the Missouri Department of Health and Senior Services, Bureau of Vital Records.
Who can use this form
- Family members, such as a spouse, parent, child, sibling or grandparent
- Other relatives, such as an aunt, uncle, in-law or cousin
- A parent or legal guardian of a minor
- An attorney or funeral director acting for the family
- A legal representative with proof of the relationship
What to send with it
- The completed application, signed and notarized
- A copy of your valid photo ID, or two secondary IDs
- The state fee by check or money order payable to the Missouri Department of Health and Senior Services
- A self-addressed stamped return envelope
Where to send it
- Mail to
- Missouri Department of Health and Senior Services Bureau of Vital Records 930 Wildwood Drive Jefferson City, MO 65109
- State fee
- $14 for the first copy, $11 for each additional copy
- Typical processing
- About 4 to 8 weeks by mail
- Source
- Official government page