Registering Details

To register simply print this form by pressing the print button on your browser, fill in and post to:
Deceased Preference Service, FREEPOST NEA12258, Shipley BD18 1BR. No stamp is needed.

Don't worry if you are unable to supply all of the details we ask for - you can register details by supplying just the
name and address of the deceased but the more details you can supply, the more it will help us.
DETAILS OF THE DECEASED All fields marked * should be completed
(Mr/Mrs/Miss/Other)*
  
Forenames*
  
 
Surname*
Address*
 
Town*
  
County
Postcode*
  
Telephone No
Date of birth
 - -
Date of death*
- -
Death certificate number

If you have a copy of the death certificate, the death certificate number can be found in the top right hand corner above the 'CERTIFIED COPY OF AN ENTRY" title.

Please leave this field blank if you do not have the death certificate or the number - you can still register details without it.

YOUR DETAILS
Forenames
  
Surname
Your postcode
Contact details

Please give a contact telephone number or e-mail address so we can contact you if there are any problems with your registration.

YOUR RELATIONSHIP TO THE DECEASED (please tick)
Spouse
Other family member
Grandchild
Son/Daughter
Funeral Director
Grandparent
Parent
Partner
Friend
   
New Occupier of deceased's former address