East Chicago, IN

Death Certificate Request

East Chicago Health Department
Vital Records Section
100 W Chicago Avenue
East Chicago, IN 46312
Application for Search & Certified Copy of Death Record
Disclaimer*
These certificates are only generated for individuals whom have passed in the city of East Chicago.
Please note, death records in the state of vital records office begin in 1900
Death registration in East Chicago began in 1927. Prior to 1900, records of death are filed only with the Local Health Department in the county where the death actually occurred.

There are no indexes to the state health for death certificates from 1900 through 1918.
Identification of the requester is required. Please do not send the originals in the mail.
Name of the Deceased
Date of Death
Date of Death
Still birth?
1. Yes
2. No
Place of Death - City
Place of Death - County
Search Fee
Search Fee Start Date
—
Search Fee End Date
A search fee of $12 will be administered if the exact date of death is not known. Please indicate the 5 year period to be searched.

An additional $12 is required for each additional 5 year period search.

Search fees are not refundable.
Date of Birth of the Deceased (If Known)
Date of Birth of the Deceased (If Known)
Father's Name
Mother's Maiden Name
Relationship to the Person on Record
Purpose for Which This Record Is Being Used
Electronic Signature Agreement
Address
City
State
Zip Code
Phone Number
Total Certificates
Fees: $12

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