Town Clerk
14 Court Square
Greenfield, MA 01301
Telephone: (413) 772-1555
Fax: (413) 772-1542
Office Hours: Monday through Friday: 8:30 a.m. - 5:00p.m.
REQUEST FOR DEATH RECORD
Please type or print the following information when requesting a death certificate:
Name of decedent: _____________________________________
Date of death: ______________________________________
Place of death: _________________________________
Name of person making request: _______________________________
Mailing Address: ___________________________________________
____________________________________________
_______________________________________________________________________________________
SIGNATURE OF APPLICANT TELEPHONE NUMBER
FEE FOR DEATH CERTIFICATES
• The fee for a certified copy is $10.00 per copy.
• Make check or money order payable to the Town of Greenfield.
• Enclose a self-addressed stamped envelope.
| 
