Gather's Death Certificate allows you to compile necessary, state-specific vital information in a way that's easy and collaborative when working with a family. We offer a variety of both required and preferred fields, available to be customized to your location.
Available Gather DC Fields by Section:
About 📝:
Decedent First, Middle, and Last Names
Last Name at Birth
Suffix
Also Known As (AKA)
Sex
Male
Female
Other
Unknown
Not Yet Determined
Social Security Number (🔒)
SSN Unknown
None
Will there be a funeral or memorial service to remember the decedent?
Yes
No
Minister Officiating
Pick Up Address
Drop Off Address
Does the facility have stairs?
Yes
No
Unknown
Does the decedent have children under 18?
Yes
No
Unknown
Number of Certified Death Certificates
Casket
Casket Panel
Insurance Company Name
Insurance Policy Number
Hair
Facial Hair
Nails
Lipstick Color
Medical Examiner Release Number
Clothing Due By (Date)
Referred to Us By
Hobbies
Lodges
Clubs
Offices
Previous Places Lived
Which Chapel?
Weight
Other
Life 🌳:
Date of Birth
Hebrew Date of Birth
City of Birth
Unknown
Date of Passing
Known
Unknown
Date
Time
Hebrew Date of Death
Date of Pronouncement
Time of Pronouncement
Cause of Death
Where did the decedent die?
As an inpatient at a hospital
In the emergency room
On the way to the hospital
At a hospice facility
At a nursing home or long-term care facility
At home
At another location
Not classifiable
Physician Name
Physician Phone Number
Physician Fax Number
Physician Physical Address
Age
Address of Decedent's Primary Residence
Unknown
Is the decedent's residence inside city limits?
Yes
No
Unknown
Years Lived in Current County
Resting Place 🪦:
Method of Disposition
Burial
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Cremation
Crematory Name
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Cremation with Burial
Crematory Name
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Cremation with Entombment
Crematory Name
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Donation
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Entombment
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Resomation
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Other
Specify Other
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Unknown
Where will the decedent be laid to rest?
Unknown or unnecessary
When will the decedent be laid to rest?
Do you own any cemetery property for the decedent?
Yes
No
Parents 👨👩👦 :
Decedent's Father
First, Middle, and Last Names
Relationship to the Decedent
Father's City of Birth
Unknown
Decedent's Mother
First, Middle, and Last Names
Relationship to the Decedent
Maiden Name
Unknown
Mother's City of Birth
Unknown
Education 📚:
Highest Level of Education Achieved
1-12th Grades (individual)
9-12th Grade, No Diploma
High School Graduate
GED Completed
High School Graduate or GED Completed
Some College Credit, but No Degree
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate (e.g. PhD, EdD)
Professional Degree (e.g. MD, DDS, DVM, LLB, JD)
Doctorate or Professional Degree
Degree Not Listed Here
Not Available
Unknown
Refuse to Answer
None
Full Education History (paragraph)
Marital Status 💍:
Married
Decedent's Spouse
First, Middle, and Last Names
Maiden Name
Maiden Name N/A
City of Marriage
Unknown
Date of Marriage
Unknown
Married, but Separated
First, Middle, and Last Names
Maiden Name
Maiden Name N/A
City of Marriage
Unknown
Date of Marriage
Unknown
Married, Died at the Same Time
Spouse's Date of Passing
First, Middle, and Last Names
Maiden Name
Maiden Name N/A
City of Marriage
Unknown
Date of Marriage
Unknown
Widowed
Spouse's Date of Passing
First, Middle, and Last Names
Maiden Name
Maiden Name N/A
City of Marriage
Unknown
Date of Marriage
Unknown
Divorced
Never Married
Unknown
Not Obtainable
Work History 💼:
Employment Status
Employed
Normal Occupation
Unknown
Kind of Business
Unknown
Name of Company
Years in Occupation
Not Employed
Normal Occupation
Unknown
Kind of Business
Unknown
Never Employed
Retired
Normal Occupation
Unknown
Kind of Business
Unknown
In what year did the decedent retire?
Last Employer (Name, City, State)
Military 🪖:
Did the decedent serve in the U.S. Military?
Yes
Which branch?
Air Force
Army
Coast Guard
Marines
Navy
Highest Military Rank
Number of Years Served
Service Dates (to, from)
Military Service Number
Military Honors
Did a service-connected disability contribute to the decedent's death?
No
Unknown
Race 🏃🏻♀️:
Ancestry
Mexican
Cuban
Arab
African
African American
English
French
Dutch
American Indian
Specify Tribe
Asian
Polish
German
Not Applicable
Is the decedent of Hispanic origin?
No, not Spanish/Hispanic/Latino
Yes, Mexican
Yes, Mexican American
Yes, Chicano
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, Cuban
Yes, Other Spanish/Hispanic/Latino
Unknown
Not Obtainable
Refuse to Answer
Race
White
Black
Black or African American
American Indian or Alaska Native
Alaska Native
American Indian
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Hispanic/Latino
Specify
Other Asian
Specify
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Specify
Other
Specify
Unknown
Refuse to Answer
Not Applicable
Is the decedent a U.S. Citizen?
Yes
No
Unknown
Informant 🙋🏾♂️:
Informant Full Name
Relationship to the Decedent
Home Address
Phone Number
(This information is collected as is and cannot be customized.)
Need More Help? 👋
Chat with our team anytime. Or give us a ring at (208) 908-0488.