Death Certificate Date

This PDF form may be printed out and completed by hand, or filled out on your computer and forwarded to Haven of Rest. DC "Historical Questions" 

We will ask you "current" information questions as required by the State of WA (You will easily know the answers to these questions) Print this form on your computer, fill it out in advance, and bring it to your appointment with Haven of Rest.

Death Certificate Form

Click on the graphic on the left to download the file.

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