Bellmawr, NJ · Camden County
Authorization for Release of Cause of Death
This form authorizes release of a death record’s cause-of-death section and is completed by a person seeking to authorize disclosure to a named recipient.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Use this form to authorize issuance of a certified copy or certification of a death record that discloses the cause of death to a named recipient. The person authorizing release provides their name and relationship to the decedent, identifies the record and recipient, and certifies the information is true. The instructions list eligible relationships and other circumstances for requesting cause-of-death information; provide documentation verifying eligibility.
Who needs it
A person authorizing release of a death record’s cause-of-death section to a named recipient should complete this form and provide documentation verifying eligibility.
Why it needs a notary
The form has a notary signature and seal area but no explicit jurat or acknowledgment wording; the person authorizing release signs before the notary.
How to get this notarized
- 1
Download The Form
Get the Authorization for Release of Cause of Death form.
- 2
Fill In The Details
Identify the authorizing person, relationship to the decedent, record type, decedent, and recipient.
- 3
Book An Online Notary
Arrange an online notarization before signing the authorization.
- 4
Sign On Video
Sign the form in the notary’s presence and complete the notary signature and seal section.
- 5
Submit The Form
Provide the signed form and documentation verifying eligibility to the appropriate records office.
Preview the form
The blank PDF straight from Bellmawr. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the cause-of-death release form?
- Enter the authorizing person’s details and relationship to the decedent, select a certified copy or certification, name the recipient, then sign before a notary. Provide documentation verifying eligibility.
- Do I need to bring proof of my relationship to the decedent?
- The form’s instructions say applicants must produce documentation verifying they qualify, such as a listed family relationship, legal authority, or another stated circumstance.
- Can I sign this form with an online notary?
- New Jersey permanently authorizes remote online notarization and remote ink notarization for its own notaries. A commissioned online notary can notarize remotely; an authorized officer’s notarial act performed elsewhere has the same effect under N.J.S.A. 52:7-10.14.
- Where do I submit the completed form?
- The form identifies the New Jersey Department of Health, Office of Vital Statistics and Registry, and lists municipal registrars in its instructions. Confirm the correct submission location with the municipality if unsure.