Submitting Your Death Records to the Warren County GenWeb Site

If you have death certificates or other sources of death records that you would like to add to the Warren County GenWeb site, you can copy and paste the following form into an email and send it to Arne H Trelvik.

The goal is to document the death of Warren Countians so the deceased should have a Warren County connection by birth, long time residence or death in the county.

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YOUR NAME:
YOUR EMAIL ADDRESS:
YOUR SOURCE FOR THE DEATH RECORD:
YOUR ADDITIONAL COMMENTS:
SCANNED IMAGE INCLUDED?:
RELATED LINKS:
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ISSUING STATE:
CERTIFICATE #:

PLACE OF DEATH
COUNTY:
TOWNSHIP:
PLACE:

FULL NAME:
MILITARY SERVICE:
RESIDENCE:
SEX:
COLOR OR RACE:
MARITAL STATUS:
SPOUSE:
DATE OF BIRTH:
AGE:
OCCUPATION:
BIRTHPLACE:
NAME OF FATHER:
BIRTHPLACE OF FATHER:
MAIDEN NAME OF MOTHER:
BIRTHPLACE OF MOTHER:
INFORMANT NAME:
INFORMANT ADDRESS:
FILED:
DATE OF DEATH:
CAUSE OF DEATH:
CONTRIBUTORY:
PLACE OF BURIAL:
DATE OF BURIAL:
UNDERTAKER:
UNDERTAKER ADDRESS:
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This page created 31 August 2003 and last updated 30-Sep-2007
© 2003  Arne H Trelvik  All rights reserved