Death Notification Information

DECEDENT ( Confirm victim's ID)

Name: _______________________________________________________

M / F  DOB: _________         Marital Status: _______

# children & ages: ___________________        Occupation: _____________

Known facts: __________________________________________________

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NEXT OF KIN ( Confirm who you will be telling)

Name(s): ______________________________________________________

Relationship to deceased (if known): ________________________________

Health status (if known): __________________________________________

Address:_____________________________ Ph.# _____________________

Name of officer : _______________________________________________

If out of county, contact: ________________Ph.# ____________________

Notes : ________________________________________________________

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