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Get Mi Dch-0856 2018-2024

CORRECT DEATH RECORD AND PROPER FEE TO: Vital Records Changes PO Box 30721 Lansing MI 48909 (PERSON REQUESTING CHANGE OR CORRECTION) Applicants Name Driver's License or State Identification # Address Daytime Phone Required PLEASE PRINT CLEARLY AND LEGIBLY City/State ( ) Zip Other Phone ( ) To protect from identity theft, PHOTO IDENTIFICATION must be presented along with this application. (See back for details) ELIGIBILITY - Please check the applicable category (Do not use for phys.

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