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Orange County Government, Indiana
Health Department
205 E Main St Suite 9
Paoli, IN 47454
(812) 723-7112
Fax (812) 723-7117
Website:
health.orangecounty59.us
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DEATH CERTIFICATE REQUEST FORM
OBTAINING A DEATH CERTIFICATE:
The purchaser must have a direct interest or be an immediate direct kinship (parent, adult sibling, or grandparent) to the person named on the record.
See Indiana Codes: 16-37-1-10, 16-37-1-11, and 16-37-1-11.
05/10/2021
BIRTH CERTIFICATE REQUEST FORM
OBTAINING A BIRTH CERTIFICATE:
The purchaser must have a direct interest or be an immediate direct kinship (parent, adult sibling, or grandparent) to the person named on the record.
See Indiana Codes: 16-37-1-10, 16-37-1-11, and 16-37-1-11.5
05/10/2021
AUTHORIZATION FOR A THIRD PARTY ADULT TO OBTAIN BIRTH CERTIFICATE
An adult may authorize another adult to obtain his/her own Birth Certificate or that of his/her minor child (18 and under), by completing form and have it notarized to present at the Vital Records office, when not able to do so him/herself in perso
05/10/2021