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Please go slowly and enter the information carefully before submitting.
Only records for ancestors who's birth or death took place in Todd County will be accepted.
No Records after 1949 will be accepted, if submitted they will be deleted immediately.
This information will be immediately posted to the Todd County Death Records Data Base.

Death Record Information:

Certificate Number   Full  Name: 

Sex:   Race:   Martial status: 

Date of Birth:   Place of Birth : 

Age:    Date of Death: 
Place of Death:(city, county, state) 


Parent Information:

Father's name:  Place of birth:

Mother's maiden name:   Place of birth: 


Cemetery Information:

Name of cemetery:    Location (city, county, state)  : 

Submitted by:   Email Address: 

Once you have completed all the information and checked it for accuracy, click "Submit Death Record." You will be taken to the Mail Merge form, click on "Click Here to Exit!"

Return to Vital Records Main Page

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