A Court Order Delayed Registration of Death VS 109 (PDF) form is utilized to register a death certificate when:
Supporting documents are used to support the information being amended. Required documents include the following:
A certified court order is required when submitting a Court Order Delayed Registration of Death.
A notarized Sworn Statement, completed by an authorized person, is required to receive a certified authorized copy of the amended certificate. Please visit the Authorized Copy vs. Informational Copy webpage for a list of authorized persons.
A “certified” copy of the court order must be a copy of the order that was originally prepared by the court and signed by the judge. It cannot be an original printout. The photocopy you receive from the court must have all of the following:
Please refer to the Processing
Times webpage for current processing times.
Court Order Delayed Registration of Death VS 109 (PDF) form and sample (PDF) form
Amendment Sworn Statements (English) (PDF) (Spanish) (PDF)
Court Order Delayed (PDF) pamphlet
(Español) Certificados Retrasados por Orden Judicial (PDF)
Directory of County Vital Record Offices
General Birth Amendment
Court Order Name Change
Correcting a Sex Field Error
Acknowledgement of Paternity/Parentage
Adjudication of Facts of Parentage
Supplemental Name Report
Delayed Registration of Birth
Court Order Delayed Registration of Birth
Court Order Delayed Registration of Marriage
Court Order Delayed Registration of Fetal Death