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Tennessee · Death

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
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Tennessee Application for Verification of Death Information (PH-3055) | Tennessee Form