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Death Record Files Application


  2. Skokie Seal

  3. *Death must have occurred in Skokie.

  4. FEE: $12.00 for the first copy and $7.00 for each additional copy ordered at the same time. You may pay by CASH, CHECK or CREDIT CARD (Master Card, Visa, or Discover) I certify that I am a relative, funeral director, duly authorized agent, have a vested property interest and therefore am entitled to purchase death certificates for the above named individual. If requesting certificates by mail you must include a copy of a valid photo ID and S/H rates may apply, please call 847-933-8252 for S/H rates.

  5. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  6. Please call the Skokie Health Department to verbally submit payment for your application.


  7. Applications are not complete until a copy of your government issued ID is received.

  8. Leave This Blank:

  9. This field is not part of the form submission.