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PLC:

a002h8

Agency:

clinton county clerk

For:

certified copies - death

Phone:

989-224-5140

Address:

100 east state street,,suite 2600
st. johns, michigan 48879

*Required Field

Payment Information

Death must have occurred in Clinton County, MI

*Name of Deceased:

Middle:

*Last:

*Date of Death:

(Month / Day / Year)

*# of Copies:

*Name to be mailed to::

*Mailing Address:

If you fail to provide a valid phone number the county clerk's office is not responsible for charges that you authorize.

*Phone number::

(### - ### - ####)

Additional Information:

Payment Amount

Payment Amount :

Subtotal:

$0.00

Total:

$0.00

Billing Information

*First Name:

Middle Initial:

*Last Name:

*Billing Address:

*City:

*State/Province:

*Zip:

*Country:

*Phone Number:

*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

*Card Security Number:

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