Death Registration Form (In Respect of the Death of an Indian National)

HIGH COMMISSION OF INDIA

36-38,GALLE ROAD

COLOMBO-3

Death Registration Form (in respect of the death of an Indian national)

1. Name & Surname of the deceased (Name or forename should be written in full, followed by surname to be written in Block letters):

2. Passport Details of the deceased

a) Passport No

b) Date of Issue

c) Place of Issue

3. Address In India

4. When & where died ( Date and month in words, year in figures, place of death as precisely as can be ascertained):

5. Sex ( Male or Female):

6. Age (in complete years, months and days):

7. Cause of Death

Please enclose following Sri Lankan documents :-

a) Post Mortem Report/Cause of Death Form

b) Inquirer’s Certificate of death – with permission to perform last rites in India/Sri Lanka

c) Death Certificate issued by Registrar of Marriages,Births and Death in Sri Lanka

8. Profession or occupation and claim to citizenship of India:

9. Place of residence at the time of death:

10. Purpose of visit to Sri Lanka:

a)Type of Visa

b) Valid upto

11. Details of next of kin of deceased

a) Name

b) Passport No

c) Address in India

d) Address in Sri Lanka

e) Telephone

f) E-mail

12. Name, Passport No.,description i.e. relationship (if any between the applicant/ informant and the deceased) address, telephone no of applicant/ informant:

13. Signature of applicant/ informant with date:

High Commission of India

Colombo

Authorisation from next of Kin of deceased

I, ______son/daughter /wife /brother /sister of______do hereby authorise Shri/ Smt______to take over the body of late______who died in Sri Lanka on______. He/she is auhtorised to complete all legal formalities on my behalf for transporting the mortal remains to India, as I am unable to visit Sri Lanka personally.

I request to High Commission of India to issue no objection certificate for transportation of mortal remains of late______to India.

Name

Address

(Please attach a copy of valid ID proof)