Get the free Extended Fact of Death (with cause of death) (for insurance benefit claims)

DEPARTMENT OF HEALTH SERVICES Division of Public Health F05280 (Rev. 11/2016)STATE OF WISCONSIN Wis. Stat. 69.21-Page 1 of 2Sawyer County Register of DeedsWISCONSIN DEATH CERTIFICATE APPLICATIONTYPE

How to fill out extended fact of death

How to fill out extended fact of death

1. To fill out the extended fact of death form, follow these steps:
2. Start by entering the deceased's personal information such as full name, date of birth, and social security number.
3. Next, provide details about the date, time, and location of death.
4. Include any relevant medical information, including the cause of death and any contributing factors.
5. Provide information about the deceased's marital status and surviving spouse, if applicable.
6. If the deceased had any children, provide their names and contact information.
7. Fill out details about the deceased's parents, including their names and any surviving parents.
8. Include information about the funeral arrangements and the name of the funeral home handling the arrangements.
9. Lastly, sign and date the form to certify that the information provided is accurate and truthful.

Who needs extended fact of death?

1. The extended fact of death form is typically required by various individuals or entities, including:
2. - Funeral homes or crematoriums responsible for handling the burial or cremation of the deceased.
3. - Government agencies responsible for processing death records and issuing official death certificates.
4. - Insurance companies that need proof of death in order to process life insurance claims.
5. - Legal professionals involved in the settlement of the deceased's estate or handling any legal matters.
6. - Next of kin or family members who may need to provide the form for administrative or personal reasons.

For pdfFiller’s FAQs

What is extended fact of death?

Extended fact of death is a form that must be filed with the relevant authorities to officially report a death.

Who is required to file extended fact of death?

The next of kin or a designated representative of the deceased individual is usually required to file the extended fact of death.

How to fill out extended fact of death?

The extended fact of death form typically requires information such as the deceased individual's personal details, cause of death, place of death, and date of death.

What is the purpose of extended fact of death?

The purpose of extended fact of death is to provide an official record of an individual's death for legal and administrative purposes.

What information must be reported on extended fact of death?

Information such as the deceased individual's personal details, cause of death, place of death, and date of death must be reported on the extended fact of death.

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