Visit the Virginia Department of Health Website 2. Instructions: The requester - the person submitting this application - must show an acceptable identification document(s) from the list on the back of this form and provide payment to the Department of Motor Vehicles (DMV). Customers use this form to request a Virginia death, marriage or divorce certificate in person. Virginia State Anatomical Program (VSAP) Please make check or money order payable to State Health Department. Death Certificate Information: Memorandum dated March 18, 2011 from Janet Rainey, Director and State Registrar, VDH Division of Vital Records, regarding computer generated death certificates How to Get a Virginia Death Certificate Copy. The Code of Virginia requires a cost of $12.00 per certificate/search. Once you generate the Application online, the Office of Vital Records issues an Application (Tracking) ID to track your Application Status Online. Read the letter from the State Health Commissioner and the Board of Medicine's Executive Director on the Completion of Death Certificates. PLACE OF DEATH (CITY OR COUNTY) CERTIFICATE NUMBER OR STATE FILE NUMBER. COMMONWEALTH OF VIRGINIA Application for Certification of a Vital Record Virginia statutes require a fee of $12.00 be charged for each certification of a vital record or for a search of the files when no certification is made. If you go to their website, you can fill out a Virginia Death Certificate Request Form online. A DEATH CERTIFICATE. COUNTY OR CITY IN WHICH DECEDENT RESIDED AS OF THE DATE OF DEATH. In re: NAME OF DECEDENT DATE OF DEATH. Provide Full Nmae and Date of the Deceased 4. You will receive Email/SMS updates on the status of your application by providing your email address and Mobile phone number. Provide Proof of Identification and Relationship 5. 1. Physician’s Designee- Section 32.1-263 (C) authorizes a physician to designate individuals to complete and sign the medical certification on a death certificate. COMMONWEALTH OF VIRGINIA VA. CODE § 32.1-269.1. Fill out the Death Certificate Request Form 3.