What information does my family need to fill out my death certificate? Print

Vital Statistical Information for Texas Death Certificate

Even in death, there is paper work.

The following minimum vital statistics from the family or the decedent (if done through a prearrangement) will be required to complete the death certificate in Texas.  If you preplanning your final disposition, give this information to your family and/or close friends.  The funeral director needs this information to complete the required death certificate.

Name of Decedent


Decedent's Address (Street, City-Town, State/Zip, County)

Sex:  Male / Female


Citizen USA:  Yes / No

Decedent's Birthplace

Decedent's Date of Birth

Father's Name  /  His Birthplace

Mother's Name  /  Her Birthplace

Marital Status

Surviving Spouse Name

Date & Place of Marriage

Employment Status:  Retired (Year??)  /  Presently Employed  /  Not Employed

Usual Occupation

Kind of Business


Employed Number of Years

Social Security Number

Highest Education

Veteran:  Yes / No

Branch of Service


Service Dates

Service Number




* Sample Vital Statistics Questionnaire - see page 2 (DFW Area Funeral Home)

* Prior to death, may I declare in a legally binding form my wishes for final body disposition?

* Prior to death, may I appoint an agent to make all decisions about my final body disposition?