Deceased Person Registration Transfer Request Form
Submit a request to transfer registration records for a deceased individual. Please complete all sections accurately to ensure timely processing.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the Deceased
*
Please Select
Next of Kin
Executor/Legal Representative
Family Member
Friend
Other
Deceased Person's Full Name
*
First Name
Last Name
Deceased Person's Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of Death
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Registration/Account to be Transferred
*
Upload Proof of Death or Supporting Document
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Reason for Transfer & Additional Notes
Submit Transfer Request
Should be Empty: