ACCOUNT_FIRST_NAME  ACCOUNT_LAST_NAME

ACCOUNT_ADDRESS_SINGLE_LINE

ACCOUNT_PHONE_NO ACCOUNT_EMAIL

To AUTHORITY, 

ADDRESS

27 December 2024

Dear Sir or Madam, 

Re: Request for Birth Certificate - Ref. no:  

I am writing with the intention to make a formal request for a death certificate. Below is the information of the passed one I hereby make request for:

Name: [insert name of the passed one]

Sex: [Male]/[Female]

Birthday: [Day]/[Month]/[Year]

Died on: [Day]/[Month]/[Year] 

To assist in locating and providing the requested certificate, I am including the following information:

Father's full name: [insert the name of the passed one's father]

Mother's full name: [insert the name of the passed one's mother]

Place of death: [insert place of death]

........................................