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Certified Death Certificate Request Form Class County Health Department 512 High St. Logan sport, IN 46947 (574) 7537761 Phone Name of Deceased: Date of Death: County of Death Requestors Relationship

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512 High St is the address of a specific location or building.

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The entity or individual responsible for the property located at 512 High St may be required to file.

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The form or documentation required to fill out 512 High St may vary depending on the specific purpose or requirements.

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The purpose of 512 High St may be related to property ownership, registration, or other legal or administrative functions.

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Information such as property owner's name, address, contact information, property details, and other relevant data may need to be reported on 512 High St.