Union County Coroner Office

 

Union County Coroner Office  128 South Main Street Marysville, Ohio 43040 

REPORT REQUEST FORM   REQUESTER INFORMATION

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Name:________________________________________________ Company:_____________________________________________ Street Address:_________________________________________ City:__________________________________________________ State:_________________________________________________ Zip:___________________________________________________ Email Address:__________________________________________

TYPE of REPORT Coroner Report: Autopsy Report (next of kin only):

RETURN DELIVERY METHOD US Postal Service: Email:

DECEASED INFORMATION Name:________________________________________________ County Death Occurred in:________________________________ Date of Death:__________________________________________

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