Create Request - Death

WINDOW OVERVIEW:

The Create Request - Death tab is used to request a death certificate or verification of death.

The tab is available on the row of smaller tabs when the Verifications and Certificate Requests tab has been opened from the Interface icon on the Person Detail window.

FIELD DESCRIPTIONS:

Enter Death Certificate Information

Select Request Type:  Click on the appropriate radio button.

m NE Verification

m NE Certified

m Out of State

Column 1

First Name:  Enter the person's first name.  This is a required field.

Middle Name:  Enter the person's middle name if they have one.

Last Name:  Enter the person's last name.  This is a required field.

Ext:  Enter the person's
Jr. Sr. III. etc.name extension if they have one.

Birth Date:  Enter the person's date of birth (MM-DD-YYYY).  This is a required field.  The calendar icon may be used to find the date.  

Column 2

Date of Death:  Enter the person's death date. (MM-DD-YYYY).  The calendar icon may be used to find the date.  

SSN:  Enter the person's social security number.

City:  Enter the name of the city where the person was born.  This is a required field.

State:  If Out of State is selected enter the name of the state where the person was born.  For Nebraska requests this field is completed.

County:  Enter the county where the person was born.

ACTION BUTTONS:

	For Nebraska Requests
	For Nebraska Certified Copies
	For Out of State Requests

(11-2007)