Request for photo copy
of Tennessee Death Certificate (1908-1953)
You may request as many photo copy certificates as you like.
Please fill out this form, send
$7.00 for each one and includea self addressed stamped #10 size
(like your bills come in) envelope.Fill in the name, date of death, vol. # and certificate/page# for each one.
Name
/ County / Date of Death / Vol.# / Cert or page#1. ___________________________________________________
2. ____________________________________________________
3. ____________________________________________________
4. ____________________________________________________
5. ____________________________________________________
6. ____________________________________________________
7. ____________________________________________________
Your Name ____________________________________
Your address ___________________________________
___________________________________
Email ______________________________
Mail this page, a money order (which I prefer. You can get them from the Post Office) or a check and a self addressed stamped (make sure you put enough postage on the return envelope) #10 size (like your bills come in) ( or larger size, if you will be needing it) envelope to:
Jay Odom
3002 Blake St.
Corinth, TX
76210
*Females should be listed by last married name or the name they were
using at time of death.
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