Average application processing time is 6-12 weeks.
Processing time is subject to change, dependent on volume of incoming applications.
Warning: False application for a vital record is a criminal offense and punishable by fine and/or imprisonment. New Mexico Vital Records requires
a photocopy of your government issued picture identification.
1. APPLICANT:
Complete each item on application legibly. An incomplete application will be rejected.
Name of Applicant
Name of Agency (If Applicant is Organization)
Mailing Address (include City, State and Zip code)
Provide physical address, If mailing address is PO box.
Daytime Telephone Number
Alternate Daytime Telephone Number
( )
( )
Only immediate family is eligible to obtain a vital record. Immediate family is defined as registrant’s mother, father, sibling, child,
grandc hild, current spouse, maternal-grandparent and paternal-grandparent. Father and paternal grandparent are only eligible if
father is listed on birth record. Non-immediate family must provide tangible proof of legal interest for requested record.
2. Applicant’s Relationship: What is your relationship to the person on the certificate
Daughter
Son
Mother
Father
Brother Sister
Grandchild
Current Spouse
Maternal Grandparent
Paternal Grandparent
Other (Specify)
3. Decedent’s Full Name at death: Print First, Middle and Last name of person named on certificate (mandatory)
Gender
Date of death: Month/Day/Year (mandatory)
Place of Death: City/County
New Mexico
Social Security Number (if known)
Date of Birth: Month/Day/Year (If known)
Spouse’s Maiden Name (if married at time of death):
Make payment payable to: New Mexico Vital Records. The fee is for the search of the record and will include one
certified copy of record, if available. Search fee is non-refundable if record is not filed.
4. Payment & Quantity
5. Purpose of Request: Check the reason(s) for use
Quantity Death Certificate @ $ 5.00:
Amendment to Vital Record
Estate/ Probate
Discharge Loan
Quantity
Chargeable Amendment @ $ 10.00:
Genealogy
Legal
Insurance
Medical
TOTAL Fees Enclosed:
$
Passport/Visa
Social Security
Tax Purpose
Check
Money Order
CASH
Other (state other
reason):
Check or Money Order Number:
Signature of Applicant
Date of Application
New Mexico Bureau of Vital Records
www.vitalrecordsnm.org
1-866-534-0051
Identification Type:
State Identification Issued:
Identification Number:
ID Expiration Date:
This section for Vital Records Use Only
Mail Application to:
New Mexico Vital Records and Health Statistics
2554 Camino Entrada
Post Office Box 26110
Santa Fe, NM 87502
Order No:
SP#:
Clerk:
Date:
DEATH RECORD
SEARCH APPLICATION
Email Address
