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Death Certificate

Death Certificate & Obituary Information

Click on the PDF icon to download our form

If you prefer to download our form please fill out the information needed for the obituary and the State of Idaho Certified Death Certificate. If you do not want us to do an obituary, all information on the left column, and on the right column informant's name and address are required for the death certificate. The information about hobbies and beyond is not required. None of page two is required.

The form can be filled out on your computer, downloaded and then emailed to wood@woodfuneralhome.com or printed and filled out by hand. If you fill it out by hand, please bring the completed form to the funeral home or fax it to 208-522-5413. Or if you prefer to submit online, scroll below.

The following form may be used to send us the information needed for the obituary and the State of Idaho Certified Death Certificate. Please fill in the following information and click submit.

Please Note: If you are only sending information for the certified death certificate, you only need to fill in the items indicated with an asterisk (*).

Death Certificate & Obituary Form

Date of Death:

*First Name of Deceased:

*Middle Name of Deceased (If Applicable):

*Last Name of Deceased:

Preferred Name:

*Age of Deceased:

*Social Security Number

*Date of Birth of Deceased:

*Place of Birth of Deceased (City, State, Country):

*Residence Address of Deceased (Street, City, State, ZIP

*Is Address Inside City Limits?:

Yes

*Marital Status:

*If Married, Full (Maiden) Name of Spouse:

*Father's Full Name:

*Birth State of Father:

*Mother's Full MAIDEN Name:

*Birth State of Mother:

*Name of Family Representative:

*Relationship to Deceased:

Street:

City:

State/Province:

ZIP/Postcode:

*Phone Number:

Email Address:

*Would you prefer traditional burial or cremation?:

*If burial, please indicate the cemetery:

*What was the main occupation of the deceased?:

*What was the highest level of education completed?:

*Race (If Native American, please include Tribe.:

*Doctor's Name:

*Place Where Death Occurred:

Free Text

If you would like us to help you write an obituary, please fill out the rest of the form.

Name of Current Spouse (If Applicable):

Date of Marriage:

Place of Marriage:

Additional Comments Related to Marriage Information

Is Spouse Still Living?:

Yes

If not, please give date of death.:

Free Text

FAMILY INFORMATION: Please list the names of living family members (survivors) and their relationship to the deceased. Please also indicate their spouse's names (if applicable) and the city in which they live as you wish to have them listed in the obituary. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, (e.g. son: Joe Smith and wife Paula of Idaho Falls, ID)

Survivors:

Preceded in Death By:

Location of Funeral Services:

Name of Officiatant:

Would you like a visitation prior to the service?:

Yes

Please indicate requested evening visitation times. (if so desired):

Name of Cemetery:

City and State of Cemetery:

Space, Lot #, or Next to, etc.

Any Comments/Details that were not discussed above:

Which Funeral Home location would your family prefer to use?:

Ammon, Idaho Location

Idaho Falls, Idaho Location

Was deceased a Veteran?:

Yes

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Idaho Falls Location

Fax: 208-522-5413

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Ammon Location

Fax: 208-542-0370

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