Tennessee Application for Verification of Death Information (PH-3055)
Official state formRecord search and verificationForm PH-3055Free downloadLast verified November 10, 2026
Request that the Tennessee Office of Vital Records search its records for a death and send verification of the information. The $15.00 search fee is charged even if no record is found. Mailed to the office.
Who can use this form
- The form is for an individual or a requesting agency. No other eligibility rules are printed.
- The office keeps death records for the past 50 years. Earlier years are at the State Library & Archives.
What to send with it
- The completed form, signed by hand in original ink. It cannot be processed unsigned.
- The name and mailing address where the verification should be sent.
- Any details you have: name of the deceased, date and place of death, and the parents' names.
- A $15.00 check or money order payable to Tennessee Vital Records.
Where to send it
- Mail to
- Tennessee Department of Health Office of Vital Records Andrew Johnson Tower, 1st Floor 710 James Robertson Parkway Nashville, TN 37243
- State fee
- $15.00 search fee, as printed on the form. It is charged even if no record is found.
- Typical processing
- Not provided
- Form revision
- Rev. 09/2026
- Source
- Official government page