Death Certificate Information Form

Personal Details

Legal Name*:

Legal Address*:

Address*:

City*:

Country*:

State/Province*:

Zip/Postal code*:

Phone:

Date of Birth*:

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Age*:

City & State Where Born*:

Social Security #*:

Father's Name*:

Mother's Name (Including Maiden Name)*:

Highest Level of Education (in years)*:

Most Recent Occupation*:

City & State of Occupation*:

Marital Status*:

Name of Spouse (if Married):

Ever Served In U.S. Military*:

If Served, Named of Branch and Years of Service:

Name of Informant (Person in Charge of Arrangements)*:

Address of Informant

Address*:

City*:

Country*:

State/Province*:

Zip/Postal code*:

Phone Number for Informant*:

Email Address for Informant*:

Contact Information

142 West Washington Avenue,
Washington, NJ 07882
Phone: (908) 689-0046
Email: knolldevoefh@gmail.com

Christopher Knoll, Manager - Director of Funeral and Cremation Services NJ License No. 4460

Get Directions

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Death Certificate Information Form

Required Information for Death Certificate

Address of Informant

Contact Information

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