AMA Physicians Report Created 3/27/2015 8:00:08 AM

Obituary/Death Notice Search Request Form
Name
Telephone
Email
Address
City
State/Province
Zip
I prefer my results:
Mailed
E-mailed
Both
Fees: $20.00 per name submitted – please make checks or money orders payable to the City of Dearborn.
Name of Deceased
Death Date (exact)*
Last Residence (city)
Amount ($)
Total
The Dearborn Public Library cannot guarantee that an obituary or death notice will be located. Please
allow 30 days for search results.
* If exact death date is not known, try to narrow dates down to month and year.
Mail this completed form along with check or money order to the following address:
Henry Ford Centennial Library
16301 Michigan Avenue
Dearborn, MI 48126
Attn: Adult Services
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