SFN 420, Request to Division of Vital Statistics for Confidential Verification of Death 400-19-165-55

(Revised 6/1/10 ML #3218)

View Archives

 

 

SFN 420, Request to Division of Vital Statistics for Confidential Verification of Death form is to be used to obtain death information from the Division of Vital Statistics, North Dakota Department of Health, Judicial Wing, 1st Floor, 600 East Boulevard Avenue, Bismarck, North Dakota 58505.

 

A stamped, self-addressed envelope will facilitate a prompt reply. The identifying information about the person should be completed in full by the county social service office before submission to Vital Statistics.

 

This form is available through the Department of Human Services and may also be obtained electronically via E-Forms. (57kb pdf)

 

E-Forms are presented in Adobe Acrobat and require the Adobe Acrobat reader.  If you do not currently have Adobe Acrobat reader installed, you may download a free copy by clicking the Get Adobe Reader icon below.