Who can request a noncertified death record?

The application states that anyone may buy a noncertified death record for a Minnesota death. Noncertified copies print on plain paper and are for informational use only.

How do I submit the application?

Mail the application and payment to the Vital Records Office at the address on the form, or fax it to 612-348-2010. Checks or money orders must be payable to Hennepin County Treasurer; do not send cash.

What payment does the application list?

The form lists $13 for one noncertified copy, $6 for each additional copy, and an optional $20 faster-processing fee. Fees are due with the application and are non-refundable.

Hennepin County, MN · Hennepin County

No notary required

Noncertified Death Record Application

Anyone may use this application to request a noncertified copy of a death record for a death in Minnesota from Hennepin County.

At a glance

Issued by: City of Hennepin County · Hennepin County, Hennepin County, Minnesota
Notarization: Not required: file this form without a notary.
Official source: hennepincounty.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

The application requests a noncertified death record, which prints on plain paper and is for informational use only. It asks for details about the deceased, requester contact and mailing information, copy quantity, processing preference, and payment. The form lists fees and payment instructions, and says incomplete or unpaid applications are returned.

Who needs it

Anyone requesting a noncertified death record for a Minnesota death may use this application.

How to submit it

Mail the application and payment to the Vital Records Office at the Hennepin County Government Center address on the form, or fax it to 612-348-2010. Make checks or money orders payable to Hennepin County Treasurer; do not send cash.

About notarization

This application does not require a notary; the document mentions no notarized attachment or related sworn step, and directs applicants to complete the form and payment.

How to submit this form

1
Download the Application
Download the Noncertified Death Record Application PDF.
2
Complete the Application
Provide the required information about the deceased, requester details, copy quantity, and processing preference.
3
Prepare Payment
Calculate the amount due and include a check or money order payable to Hennepin County Treasurer. Do not send cash.
4
Submit to the Vital Records Office
Mail the application and payment to the address on the form, or fax the application to 612-348-2010.

Frequently asked questions

Who can request a noncertified death record?: The application states that anyone may buy a noncertified death record for a Minnesota death. Noncertified copies print on plain paper and are for informational use only.
How do I submit the application?: Mail the application and payment to the Vital Records Office at the address on the form, or fax it to 612-348-2010. Checks or money orders must be payable to Hennepin County Treasurer; do not send cash.
What payment does the application list?: The form lists $13 for one noncertified copy, $6 for each additional copy, and an optional $20 faster-processing fee. Fees are due with the application and are non-refundable.
Do I need a notary for the Noncertified Death Record Application?: No. The application does not require a notary and mentions no notarized attachment or related sworn step; complete the form and include payment as directed.

Need something notarized?

This Noncertified Death Record Application doesn’t need a notary, but if you have another Hennepin County form that does, a commissioned online notary can help.