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BMD-003Mandatory

Petition to Establish Fact, Date, and Place of Death

California · Judicial Council of California · Effective September 1, 2018

This form is used to ask the court to make an official order that confirms the fact, date, and place of a death when there is no official record or when a record cannot be obtained. It asks the petitioner to provide details about the person who died and the circumstances of the death.

The court describes it as: Ask the court for a decision (order) establishing the fact, date, and place of a death when no record of the death was made before or you cannot get a record of the death.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Start a case

Stage: Start a case

This form is used when someone needs the court to officially confirm the details of a death because the death was not recorded, or a record cannot be found. Petitioners must also prepare a specific order form (VS 109) to submit to the court.

Usually filed by the person starting the case.

Common questions

Who fills out this form?
The petitioner fills out this form, which is the person asking the court for the order. You must also provide an order form issued by the California Department of Public Health Vital Records (CDPH Vital Records).
What do I need to submit with this form?
You must provide a completed order form (VS 109) and a copy of the signed order certified by the court clerk. You also need to file a Declaration in Support of Petition to Establish Fact, Time, and Place of Death (form BMD-003A).
Is there a filing fee mentioned?
The form text does not mention any specific filing fees.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect September 1, 2018.

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