Embedded Files
therefor. In most cases, the best qualified person to obtain the personal information from, the informant, is a member or friend of the family. The following individuals can be the informant and are listed in order of preference: spouse, a parent, a child of the decedent, another relative, or other person who has knowledge of the facts. Whatever the source may be, the name, relationship to decedent, and mailing address of the informant must appear on the certificate in the space provided. It is essential that certificates and reports be prepared as permanent durable records. Completing a death certificate involves the following guidelines: + Use the current form designated by the State. + Complete each item, following the specific instructions for that item. + Make the entry legible. Use a computer printer with high resolution, typewriter with good black ribbon and clean keys, or print legibly using permanent black ink. + Do not use abbreviations except those recommended in the specific item instructions. + Verify with the informant the spelling of names, especially those that have different spellings for the same sound (Smith or Smyth, Gail or Gayle, Wolf or Wolfe, etc.). + Refer problems not covered in these instructions to the State office of vital statistics or to the local registrar. + Obtain all signatures; rubber stamps or other facsimile signatures are not acceptable. If jurisdiction permits, authenticate electronically. 10 + Do not make alterations or erasures. + File the original certificate or report with the registrar. Reproductions or duplicates are not acceptable. 11 Part II—Completing the Certificate of Death These instructions pertain to the 2003 revision of the U.S. Standard Certificate of Death. Usually the funeral director completes items 1–23 and 51–55, and the medical certifier completes the remaining items. Items to be completed or verified by the funeral director (items 1–23) NAME OF DECEDENT: For use by physician or institution The left-hand margin of the certificate contains a line where the physician or hospital can write in the name of the decedent. This allows the hospital to assist in completing the death certificate before the body is removed by the funeral director. However, because the funeral director is responsible for completion of the personal information about the decedent and because the hospital frequently does not have the complete legal name of the decedent, the hospital or physician should enter the name they have for the decedent in this item. The funeral director will then enter the full legal name in item 1. 1. DECEDENT’S LEGAL NAME (Include AKAs if any) (First, Middle, Last) Enter the full first, middle, and last names of the decedent. Do not abbreviate. Do not copy any name from the left-hand margin of the certificate into item 1 on the certificate; the name in the margin may be incomplete or incorrect. If there appears to be more than one spelling of any name provided and the correct spelling cannot be verified, use the most common spelling. The name must consist of English alphabetic characters and punctuation marks. Multiple first or middle names If the informant indicates two first names separated by a space, such as ‘‘Mary Louise Carter,’’ verify that ‘‘Louise’’ is part of the first name and is not a middle name. 12 Enter the two first names with a blank space between them. If several middle names are given, enter all with a space between the names. Initials If the informant indicates that the person uses a first initial such as ‘‘E. Charles Jones,’’ try to obtain the whole first name. If the name can be obtained, enter the whole first name. If not, enter just the initial followed by a period. If the informant indicates two initials and a surname such as ‘‘H.S. Green,’’ determine if these are a first and middle initial, or two first initials with no middle name or initial. Try to obtain the whole name(s). If the names can be obtained, enter the whole names in the appropriate spaces. If there are no whole names, enter the initials in the appropriate spaces. Each initial should be followed by a period. Religious names and titles If there is a title preceding the name, such as ‘‘Doctor,’’ do not enter the title in any of the name fields. For religious names such as ‘‘Sister Mary Lawrence,’’ enter ‘‘Sister Mary’’ in the first name field. No first or middle names (infants) If a name such as ‘‘Baby Boy Watts’’ is obtained from medical records for the death of a newborn, check with the parents or other informant to see if the child had a given name. If the child had not been given a name, leave the first and middle name fields blank and enter only the surname. Aliases Complete the current legal name before entering any other names (alias or AKA, ‘‘also known as,’’ names such as AKA Smith) the decedent used or was known as. The alias should be listed if it is substantially different from the decedent’s legal name (e.g., Samuel Langhorne Clemens AKA Mark Twain, but not Jonathon 13 Doe AKA John Doe). Record the alias name with AKA preceding the name (e.g., AKA Smith). Repeat until there are no other names provided. The State may enter the full alias rather than just the part of the name that differs from the legal name. AKA does not include: + Nicknames, unless used for legal purposes or at the family’s request. + Spelling variations of the first name. + Presence or absence of middle initial. + Presence or absence of punctuation marks or spaces. + Variations
Report abuse