APPLICATION FOR A DEATH CERTIFICATE PLEASE READ THESE NOTES before completing this form.

Death Certificate Trafford : STR/71/30

1 TO BE COMPLETED BY THE APPLICANT Name of applicant Mr Mrs Miss/Ms (STATE NAME IN FULL) Full postal address   Post Code: Telephone no: e-mail address:

2 Please state your relationship to the person to whom the certificate relates:

3 DETAILS OF DEATH CERTIFICATE REQUIRED
SURNAME OF DECEASED MORRIS	DATE OF DEATH 1932
	PLACE OF DEATH (Full address or name of hospital) Stretford
FORENAME(S) Ellen
OCCUPATION	DATE OF BIRTH or AGE AT DEATH50
HOME ADDRESS	If a married woman, please give name and surname of husband

4 REQUIREMENTS	Send this Application to:
DEATH CERTIFICATE £11.00	Superintendent Registrar, Trafford Register Office, Town Hall, Sale Waterside, Sale, Cheshire, M33 7ZF, UK
I requireNUMBER death certificate(s)

5 REMITTANCE ENCLOSED  (POSTAL APPLICATIONS ONLY)

UK: applications should enclose an SAE. Postal order or cheque made payable to : Trafford Borough Council for £ 11.00 Overseas: applications should enclose a self addressed envelope and two IRCs, with payment by Bankers Sterling Draft payable to : Trafford Borough Council Non priority service - Certificates are £11.00 and will be issued within 15 working days of receipt of application (this includes 1st class royal postage and economy airmail for outside the UK) Priority service - Certificates are £35.00 and will be issued within 1 working day of receipt of application (this includes 1st class royal postage and economy airmail for outside the UK)

The Fee for a certificate issued against this form 'as printed' will not be refunded. You are strongly recommended to add any qualifying information you may have in order to help the registrar issue the correct certificate.