Revised August 2012 - royalrivergraphics.comDeath Page 7 of 37 Revised – August 2012 S:\Municipal...

$Page 1: Revised August 2012 - royalrivergraphics.comDeath Page 7 of 37 Revised – August 2012 S:\Municipal Clerks Handbook\2012 Revision DEATHS IN MAINE QUICK REFERENCE GUIDE Paper Death$

Death Page 2 of 37

Revised – August 2012 S:\Municipal Clerks Handbook\2012 Revision

TABLE OF CONTENTS

Definitions.................................................................................................................................... 4

Quick Reference Guide to Deaths................................................................................................ 6

Registration of Deaths

Responsibility for Preparation ..................................................................................................... 8

Medical Certifiers ........................................................................................................................ 9

Nursing Home Deaths .................................................................................................................. 9

Medical Certification of Death .................................................................................................... 10

Time Requirements ...................................................................................................................... 10

Death Certificate Forms ............................................................................................................... 10

Copies .......................................................................................................................................... 11

Small Communities or Unorganized Towns ................................................................................ 11

Registration .................................................................................................................................. 12

Checklist for Accepting Death Certificates for Filing ................................................................. 12

Guidelines for Deaths .................................................................................................................. 13

Incomplete Certifications ............................................................................................................. 17

Presumptive Death ....................................................................................................................... 18

Deaths Occurring on Vessels or Aircraft on the High Seas ......................................................... 18

Medical Examiner Cases.............................................................................................................. 18

Disposition of Human Remains

Cremation ..................................................................................................................................... 19

Fetal Remains............................................................................................................................... 20

Medical Examiner’s Release........................................................................................................ 20

Sub-Registrars .............................................................................................................................. 20

Medical Examiner’s Release Form (section begins) ................................................................... 20

Sub-Registrar’s Commission Municipal Letterhead .................................................................... 22

Permit for Disposition of Human Remains .................................................................................. 23

Disposition Permit Purposes ........................................................................................................ 24

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Permit for Disposition of Human Remains Form ........................................................................ 24

Cheat Sheet for Disposition Permits ............................................................................................ 25

Procedures for using the permit for Disposition of Human Remains ………………………… 25

Type of Disposition Permit .......................................................................................................... 26

Authorization for Disposition Permit........................................................................................... 27

Endorsement …………………………………………………………………………………... 27

Swearing in Letter for Sexton of Cemetery (sample) .................................................................. 28

Retention and Filing of the Disposition Permit ........................................................................... 29

Death Certificate Delays .............................................................................................................. 29

Report of Death ............................................................................................................................ 30

Purpose of the Report of Death .................................................................................................... 30

Communicable Diseases .............................................................................................................. 31

Transportation of Human Remains .............................................................................................. 31

Authorized Person (Issuing the Disposition Permit) ................................................................... 31

Enforcement ................................................................................................................................. 32

Disinterment ................................................................................................................................. 33

Disinterment of Cremains ............................................................................................................ 33

Disposition of Human Remains Permit for Disinterment ............................................................ 33

Conduct of Disinterment .............................................................................................................. 33

Transportation of Disinterred Bodies........................................................................................... 34

Temporary Storage....................................................................................................................... 34

Private Burying Grounds ............................................................................................................. 34

Errors on Death Certificates......................................................................................................... 35

Certificate of Abandonment …………………………………………………………………… 35

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Death Section Definitions

A. Attending Physician. The attending physician in charge of the decedent’s care during the

period preceding his or her death.

B. Authorized Person. A person other than a funeral director/funeral practitioner who

demonstrates authorization for final disposition of a dead body as required by Title 22 M.R.S.A.

§2846.

C. Certified Nurse Practitioner. An advanced practice registered nurse who is a certified nurse

practitioner authorized to practice without the supervision of a physician.

D. Dead Body. A human body or parts of a human body, other than a fetus, from the condition of

which it reasonably can be concluded that death occurred.

E. Death Certificate. The certificate of death as furnished by the State Registrar for the purpose of

registering deaths, which occur in Maine, including the medical certification of the cause of

death and personal data pertaining to the decedent.

F. Department. The State of Maine Department of Health and Human Services.

G. Disinterment. The exhumation and/or removal of a dead body from or within a cemetery.

H. Disposition Permit / Burial Transit Permit. A dead human body may not be buried, cremated

or otherwise disposed of or removed from the State until a funeral director or other authorized

person in charge of the disposition of the dead human body or its removal from the State has

obtained a permit from the State Registrar of Vital Statistics or the clerk of the municipality

where death occurred or where the establishment of a funeral director having custody of the dead

human body is located as specified by department rule, Title 22 M.R.S.A. § 2843.

I. Entombment. Placement of a dead body in a receiving vault or other structure constructed for

this purpose, prior to final disposition.

J. Fetus. A product of conception dead prior to the complete expulsion or extraction from its

mother; the fetus shows no signs of life such as beating of the heart, pulsation of the umbilical

cord, or definite movement of voluntary muscles.

K. Final Disposition. The burial, cremation, burial at sea, use by medical science, removal from

the state, or other authorized disposition of a dead body or fetus.

L. Funeral Director/Funeral Practitioner. A person licensed for the practice of funeral service in

Maine, or their agent.

M. Institution. Any establishment, public, or private, which provides in-patient medical, surgical,

or diagnostic care or treatment, custodial or domiciliary care, or to which persons are committed

by law.

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N. Issuing fee. The fee paid by a funeral director/funeral practitioner or authorized person (Title 22

M.R.S.A.§2846) for creating/issuing a Disposition of Human Remains Permit (Disposition

Permit) to the municipal clerk(s) listed in place of death, issuing clerk municipality, or

municipality of sub-registrar on the disposition permit.

O. Life-Sustaining Procedure. As specified in Title 22 M.R.S.A. §2842, any medical procedure or

intervention that, when administered to a qualified patient, will serve only to prolong the dying

process and shall not include nutrition and hydration.

P. Medical Certification. The information on the cause(s) of death and the time, date, manner, and

circumstances of death.

Q. Medical Certifier. A physician, a physician assistant, or a certified nurse practitioner who

certifies the decedent’s death.

R. Medical Examiner’s Release. A certificate from a duly appointed medical examiner that he/she

has made personal inquiry into the cause and manner of death and is satisfied that no further

examination or judicial inquiry is necessary, as specified by Title 22 M.R.S.A. §2842.

S. Municipal Clerk. The duly elected or appointed clerk of the city, town, or plantation where

death occurred, where the death certificate is required to be filed by Title 22 M.R.S.A. §2703, or

where an establishment of the funeral director/funeral practitioner having custody of the dead

body is located.

T. Official of a Municipality. The municipal clerk or, in the case of a municipality without a full-

time clerk, another elected or appointed municipal official designated in writing by the municipal

clerk to endorse the deposition permit pertaining to each burial, cremation of disinterment which

takes place in the municipality. A person who has been appointed by the municipal clerk as a

sub-registrar may not be designated as an official of the municipality for the purpose of Title 22

M.R.S.A. §2843.

U. Registration. Filing of a certificate with the municipal clerk as required by law. Registration is

complete when the municipal clerk enters the date of filing, signs the death certificate, and

forwards a copy to the State Registrar.

V. Report of Death. A statement from a funeral director/funeral practitioner, as specified by Title

22 M.R.S.A. §2843, Sub-§2, that he/she has been unable to obtain a medical certification of the

cause(s) of death. The report of death must name the medical certifier and include assurances

that the medical certifier has been contacted and will certify the death as due to natural cause.

When a medical examiner is required to determine the cause of death, the report of death must

name the medical examiner and include assurances that the medical examiner has been contacted

and has indicated that the body can be released for embalming and final disposition.

W. Sub-registrar. A person appointed by the municipal clerk of the city, town, or plantation where

the death occurred, where the death certificate is required to be filed by Title 22 M.R.S.A. §2703,

or where an establishment of the funeral director/funeral practitioner having custody and control

of the dead body is located or a person appointed by the State Vital Records office as a State

Registrar.

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X. Suitable Container. A sound receptacle made of material such as wood, fiberboard, or other

rigid material, or canvas to contain a dead body.

Y. Terminally Ill Patient. A patient who has been diagnosed as having an incurable or irreversible

condition that, without the administration of life-sustaining procedures, will, in the opinion of the

medical certifier, result in death within a short time, as specified by Title 22 M.R.S.A. §2842.

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DEATHS IN MAINE

QUICK REFERENCE GUIDE

Paper Death Certificates

1. Only a Maine licensed funeral director/funeral practitioner or an authorized person (as defined by

statutes) may file a death certificate.

2. Paper death certificates are brought only to the municipal clerk at the place of death for filing.

{Electronic death certificates are filed directly with the State Registrar.}

3. All signature areas on the death certificate must be signed (signature of funeral practitioner or authorized

person and signature of medical certifier) and completed in BLACK ink, no cross outs, or unclear

copies, and the cause of death must be typed or legibly hand printed. No cursive.

4. Municipal Clerk at the place of death then reviews the death certificate for any obvious errors or

incomplete information.

5. Should any noticeable errors or incomplete information become apparent upon reviewing the personal

information on the death certificate, the municipal clerk at the place of death may correct any errors or

complete any missing personal information. The funeral director/funeral practitioner or authorized

person must be present, or made aware, and is in agreement that the information is wrong before any

changes are corrected or completed. This must be done prior to filing with a notation on the back of the

original (State copy) stating that the death certificate has been “amended before filing” accompanied by

the date in which the correction or completion was done. After the death certificate has been accepted

for filing, it cannot be changed in any way at the municipal level. Corrections or completions must be

made using the VS-7 form after it has been sent to DRVS with appropriate documentation.

6. Date of death, place of death, facility name, county of death, and city or town of death, and was autopsy

performed, autopsy findings available prior to completion of cause of death, manner of death, injury at

work, date of injury, time of injury, how injury occurred, place of injury, location and cause of death

contain data that may only be corrected or completed by the medical certifier that signed the death

certificate. A VS-7 cannot correct these items. The Office of Chief Medical Examiner or the Vital

Records office will furnish a Supplemental Certificate of Death (SCOD). The death certificate will then

become a two-page death certificate. When certified copies are made, both pages are copied onto blank

safety paper and certified; this is considered one certificate.

7. A “method of disposition” must be checked on the death certificate. This will determine if a medical

release form (VS-37) is needed to accompany the death certificate or report of death.

a) Methods of disposition that do require a medical release include cremation, burial at sea, use

by medical science, and removal from state. Retain a photocopy of the medical release form

and file the VS-37 in a separate folder that does not contain death certificates.

b) Methods of disposition that do not require a medical release are temporary storage and

burial.

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8. Clerk completes registrar’s signature certificate once the review is complete and the death certificate is

acceptable for filing. The funeral director/funeral practitioner should have three copies of the death

certificate made prior to bringing the death certificate to the municipal clerk at the place of death to be

accepted for filing. Sign all copies of the death certificate, except the place permit issued copy. The

place permit issued copy should read, “Do not issue” in the Registrar’s Signature field. Complete the

date you accepted the death certificate for filing. Forward the original death certificate to the Vital

Records office and the death certificate copies to the appropriate places indicated on the top of each

death certificate form.

9. Issuing the “Permit for Disposition of Human Remains” (VS-35). The funeral

director/funeral practitioner applying for a disposition permit must have presented a completed death

certificate (or a report of death), medical examiner release (if applicable), the required issuing fee, and

has previously made photocopies from the original Disposition Permit. The only persons authorized to

issue the Disposition of Human Remains permit are:

a) The municipal clerk at place of death

b) The municipal clerk of the municipality where the funeral establishment is located. (If a Maine

licensed funeral director/funeral practitioner)

c) Sub-registrars of either municipality or the State.

10. The municipal clerk or sub-registrar review the Disposition Permit for accuracy and determine

the completeness of the supporting documentation before granting permission for disposition by

signing all copies of the Disposition Permit. The Disposition Permit is not valid until the

municipal clerk or sub-registrar has signed it.

a) The municipal clerk at the place of death.

b) The municipal clerk where the funeral establishment is located will sign the Disposition Permit

as the issuing clerk and will state the city or town they are affiliated with along with the date the

permit was issued.

c) The sub-registrar that was appointed by either the place of death municipal clerk or the sub-

registrar that was appointed by the place of the funeral establishment municipal clerk, or the sub-

registrar of the State, will sign the Disposition Permit as the issuing sub-registrar, and will state

the city, town or State that appointed them as a sub-registrar along with the date the permit was

issued.

11. The issuing municipal clerk keeps the “Issuing Clerk-Retain Until Endorsement

Received” until the endorsed copy is returned. The other copies of the Disposition Permit are

distributed to the municipal clerks at the place of final disposition, place of death, and place permit

issued as indicated at the top of the VS-35 form.

12. In the event that fifteen days (15) have lapsed from date of death and the funeral establishment has

notified or is unable to locate and notify the person(s) responsible for the interment of remains of a

deceased now in their custody; the funeral director/funeral practitioner may apply to the municipal clerk

in the municipality where the death occurred for a Certificate of Abandonment, using a form furnished

by Maine CDC, Data, Research and Vital Statistics office. (Maine Public Law, Chapter 387, LD 1490,

effective September 2011.)

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Cheat Sheet:

- The place of death and the place the permit issued (if different) on the Disposition Permit are due a

$20.00 issuing fee.

- The issuing clerk or sub-registrar cannot sign as person in charge of final disposition on the

Disposition Permit unless the remains were placed in temporary storage and the funeral

director/funeral practitioner owns the storage facility specified.

- The place of death municipality, the place the permit issued municipality and/or the State, and place

of final disposition municipality are where the Disposition Permit is to be filed.

- Deaths at the United States Department of Veteran’s Affairs formerly known as Togus are filed at

the Vital Records office or filed by a Sub-Registrar of the State are required to file Disposition

Permits and pay a $25.00 issuing fee directly with the Data, Research and Vital Statistics office in

Augusta.

Registration of Death

When a person dies in Maine the death must be registered with the municipal clerk where the death occurred as

specified by Department regulation. The laws and rules governing death registration are included in Vital

Statistics Registration in Maine: Digest of Laws and Regulations. Deaths at the United States Department of

Veteran’s Affairs at Togus are filed at the Vital Records office.

Responsibility for Preparation

The funeral director/funeral practitioner or other authorized person who takes responsibility for final disposition

of the body is responsible for obtaining all of the personal information and entering it on the death certificate,

obtaining the medical certification including the medical certifier’s signature, making the photocopies, and

filing the death certificate with the municipal clerk at the place of death. The regulations require that the death

certificate must be filed within five days after the death occurred, unless there are unusual extenuating

circumstances (See 10-146 CMR 5, Medical Certification of Cause of Death, in the Digest of Laws and

Regulations).

It is the funeral director’s/funeral practitioner’s responsibility to make photocopies of the death certificate,

Permit for Disposition of Human Remains, and Medical Examiner’s Release form and to present them to the

municipal clerk for filing and for issuing a Permit for Disposition of Human Remains. Funeral establishments

without photocopiers must make another arrangement, with a library, post office, commercial copy service, or

with the municipal clerk. Municipal clerks may charge for this service.

The original Standard and Medical Examiner Form death certificate have been combined into one form, a legal

size form (8.5x14), which can be created on white regular photocopy (20 lb) paper. This form is in compliance

with National Center for Health Statistics (NCHS) and the electronic death registration process.

The medical certification of the cause of death must be completed in typewritten or legibly hand-printed

style. The medical certifier and medical examiner authorized to practice in the State of Maine must certify the

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cause of death, and sign the death certificate within 24-48 hours. The medical certifier must have knowledge

of the patient’s recent medical condition, except when the death falls under the jurisdiction of the medical

examiner. The funeral director/funeral practitioner or authorized person in charge of the disposition may then

file the death certificate at the municipality of place of death, and obtain the necessary Permit for Disposition of

Human Remains to dispose of the body.

Medical Certifiers (Certifying Physician*, Physician Assistant**, or Certified Nurse

Practitioner***)

Who May Certify: If the decedent’s attending physician, physician assistant or certified nurse practitioner is

unable to certify the death, someone else may do so, as specified in this section.

In all deaths from natural causes, the medical certification of the cause(s) of death must be completed and

signed by a medical certifier who is licensed or authorized to practice in the State of Maine, and who:

Attended the deceased before death, although not necessarily for the illness or condition which

caused the death, or is

Associated with the attending physician, physician assistant or certified nurse practitioner in

practice or covering for him/her during his/her absence, or is

Designated by the attending physician, physician assistant or certified nurse practitioner for

this purpose, or is

The Chief Medical Officer of the institution in which death occurred.

At the request of the Chief Medical Examiner for a physician, physician assistant or certified

nurse practitioner licensed in Massachusetts, New Hampshire, or Vermont. This is approved on

a case by case basis and requires an ME release number placed on the death certificate prior to

acceptance by the municipal clerk.

At the request of the Chief Medical Examiner for a physician, physician assistant or certified

nurse practitioner working at the United States Department of Veterans Affairs at Togus or other

federal medical facility within the state.

A physician, physician assistant or certified nurse practitioner who certify the death certificate other than the

attending physician, must have access to the recent medical history of the case, and must be certain that

death was due to natural causes. The healthcare provider must note on the death certificate that he/she is the

certifying, not the attending healthcare provider.

* Statutes and regulations, which went into effect on September 29, 1987

** Statutes and regulations, which went into effect on September 20, 2007

*** Statutes and regulations, which went into effect on September 17, 2005

Nursing Home Deaths: If the decedent was a resident of a nursing home, an attending physician, physician

assistant or certified nurse practitioner must examine the body, unless he/she has examined the patient within

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two weeks prior to death, in the case of a terminally ill patient, or within 48 hours prior to death, for all other

patients.

Medical Certification of Death

The medical certifier’s primary responsibility in death registration is reporting the cause of death. The medical

part of the death certificate includes:

If the body was found, the date and time pronounced dead

Date and time of death

Place of death

Question on whether the case was referred to the medical examiner or coroner

Injury items for cases involving injuries

Certifier section, name, address, date and signatures

In some cases, a different medical certifier will complete and certify the medical information on the death

certificate when the attending healthcare provider is unavailable to certify the cause of death at the time of

death. If an inquiry is required by a State Post-Mortem Examinations Act, a medical examiner or coroner is

responsible for determining the cause of death. Review by a Medical Examiner is required for trauma, injury,

accidents and unaccompanied deaths.

Cause: The cause of death certified need not be a condition for which the patient was specifically treated, so

long as it is reasonable and consistent with the general state of health of the patient and circumstances

surrounding the death. The cause of death must be typewritten or legibly hand-printed style. No cursive.

Time Requirements

The death certificate may be initiated by the medical certifier, or by the funeral director/funeral practitioner or

other authorized person; the deadlines for completing the medical certification depends on which procedure is

used.

Death certificates originating with the medical certifier must be completed, signed, and presented or

mailed to the funeral director/funeral practitioner or authorized person within 48 hours after death.

Death certificates originating with the funeral director/funeral practitioner or authorized person

must be completed by the medical certifier and presented or mailed to the funeral director/funeral

practitioner or authorized person within 24 hours after receipt of the death certificate.

Death Certificate Form

Deaths must be registered in the electronic death registration system. If that system is not available or

circumstances prevent the electronic filing, the death must be filed on the legal size death certificate form

(8.5x14) created to replace the former original standard and medical examiner forms. The death certificate form

is printed on white legal size (8.5x14) regular photocopy (20 LB) paper.

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The Maine death certificate underwent a total redesign and the new certificate was released for use in January

2012, to make better use of modern technology becoming consistent with the electronic death registration

system to streamline procedures and increase efficiency. This form is in compliance with National Center for

Health Statistics (NCHS) and the electronic death registration process and are similar to death certificates used

throughout the United States.

In November of 2006, Domestic Partnerships and Medical Release boxes were added to the death certificate as

well.

Printing forms on-site: Funeral directors/funeral practitioners may print their own forms using software

customized for the Maine death certificate and a laser or ink-jet printer. The DRVS must approve the format,

and the death certificate (this must correspond to State form exactly), the color, and quality of the paper used for

printing the original regular 20 lb. paper; white paper for all photocopies. The death certificate form is available

to download from the DRVS restricted access website provided for funeral directors/funeral practitioners.

Medical Certifier’s signature: The medical certifier or medical examiner certifying the death will sign the

original death certificate, before the photocopies are made for distribution.

Copies

Instead of the previous multi-copy form, the death certificate is now a single legal size page, with additional

copies made by photocopying the original after it has been signed by the medical certifier or medical examiner,

funeral director/funeral practitioner or authorized person. Marking the checkboxes at the bottom of the form

indicates the destination of each photocopy:

The original certificate, marked “Original – State” is mailed to Data, Research, and Vital

Statistics,

The first photocopy remains with the municipal clerk at the place of death,

The second photocopy is for the municipal clerk at the place of residence, if a resident of

Maine, and

The third photocopy is for the municipal clerk where the Permit for Disposition of Human

Remains is issued, if different from the place of death. The third photocopy, “Place of Issuance”,

cannot be used to issue certified copies of the death certificate. The registrar’s signature box

should read, “DO NOT ISSUE”.

Small Communities or Unorganized Towns

Confusion exists regarding where to bring or mail a death record for filing when the death occurs in small

community or in an unorganized township. Data, Research, and Vital Statistics (DRVS) maintains a listing of

unorganized townships and where the records of events occurring in these locations or communities are to be

filed. To ease confusion, the DRVS would encourage medical certifiers to enter the name of the municipality of

FILING in parenthesis after the name of the location of event in “city or town of death”, if known. Examples

of deaths where the name at the location is a community name vs. a municipal name is Deering Oaks or

Riverton, which are really sections in the city of Portland; South China is really China; Belgrade Lakes is really

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Belgrade. The DRVS is working with municipal clerks to obtain the name of the municipality along with the

signature of the Municipal Clerk when filing records for events that did not occur in their municipality. It is

equally as important when filing with the electronic process or paper process.

Registration

The municipal clerk at the place of death is responsible for the registration of deaths and fetal deaths.

When you receive a record for filing, please review it carefully for accuracy and completeness before accepting

it. The checklist on the next page includes some of the problems encountered most frequently.

Should additional information or noticeable errors become apparent during reviewing the personal information

on the death certificate which the funeral director/funeral practitioner or authorized person provides, the

municipal clerk may return the certificate to the funeral director/funeral practitioner or may correct any errors or

complete any missing personal information. This must be done prior to filing and accepting the death certificate.

A notation must be made on the back of the original (State copy) stating that it was “amended before filing”.

The funeral director/funeral practitioner or authorized person must also be present, or made aware of the

incorrect information, before any changes are made.

When the municipal clerk is satisfied that the death certificate has been properly filled out, sign the original,

place of death, and place of residence copies of the death certificate in the Registrar’s Signature box as the local

registrar, in order to accept it for filing. Enter the date you sign it in the Date Filed box. The Place Permit

Issued copy should read, “DO NOT ISSUE” in the Registrar’s Signature and Date Filed boxes.

After the municipal clerk has filed the death certificate, forward the Original to the Vital Records office. The

original death certificate will have the original medical certifier’s signature; the other photocopies should be

filed at the place of death; the place of residence (if in Maine), and the place the Permit for Disposition of

Human Remains is issued.

If the place of residence is the same as the place of death, keep the place of death photocopy only. If the place

of residence is Out of State, do not send a copy to that State. Do not file any “Out of State” death certificates

received from another State or Country. You are only allowed to file death certificates for events that occur in

Maine. If you have any questions, please contact DRVS.

Checklist: Accepting Certificates for Filing

Please do not accept certificates for filing if they are unclear. Sharp, clean photocopies are

essential for making clear, legible certified copies.

Please do not accept certificates unless all signatures are in black ink. Blue ink fades and is

not picked up well by photocopiers and scanners.

Good regular white photocopy paper (20 lb) may be used to produce all four copies of the

certificate. If you are receiving death certificates on poor paper, please let the Vital Records office

know.

Please do not use any “date received” stamp on the death certificates when they arrive in

your office! After you accept and sign the death certificate, enter the date filed.

Death Page 14 of 37


As always, review the death certificate for accuracy and completeness before accepting it for

filing – i.e., signing and dating it as the local registrar. After the death certificate has been filed, it

cannot be changed in any way at the municipal level. Corrections must be made using the VS-7 form

“Application for Correcting or Completing a Certificate” and providing the appropriate documentation.

Items to watch for:

Funeral practitioner’s signature.

Funeral practitioner’s license number.

Registrar’s (municipal clerk) signature and date filed.

“Manner of death” indicated. Date signed by medical certifier.

Cause of death must be “legibly hand printed”.

Guidelines for Completing/Reviewing Death Certificates Prior to Filing

NOTE: Only N/A or NA is acceptable,

anything else will be questioned to be corrected.

1. “DECEDENT’S LEGAL NAME” (Include AKA’s if any) (First, Middle, Last, Suffix) - This information

should either be typed or neatly hand printed. If there are items that do not apply to the name of the

decedent, these items may remain blank, e.g. middle name or Jr., Sr., etc.

2. “SEX” of the decedent - This must be either F or M.

3. “SOCIAL SECURITY NUMBER” - This either contains nine numbers or N/A.

4a. “AGE” - Last Birthday (Years)

4b. “UNDER 1 YEAR” (months and days)

4c. “UNDER 1 DAY” (hours and minutes)

5. “DATE OF BIRTH” (Mo/Day/YYYY) This must contain month, day, and year. (Review the age and the

anniversary of the birth date of the decedent (spell the month) and be sure to deduct one year from the age if the

birthday has not yet occurred).

6. “BIRTHPLACE” (City and State or Foreign Country) - This need only contain the State or Country of birth.

Although city is listed on the certificate, this is merely for genealogical purposes. ODRVS does not use that

data.

7a. “RESIDENCE-STATE” - Only the name of the state the decedent resided in is necessary.

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7b. “COUNTY” (COUNTY OF RESIDENCE) - If the residence is out of state, DRVS may be contacted to

help complete this data if unknown.

7c. “CITY OR TOWN” (RESIDENCE CITY OR TOWN)- This must be the name of the city/town the

decedent lived in.

7d. “STREET AND NUMBER” (RESIDENCE STREET AND NUMBER) –Can be physical or mailing.

7e. “APT. NO” – If there is no apartment number – N/A or NA

7f. “ZIP CODE”

8. “EVER IN US ARMED FORCES” - Either Yes or No must be checked.

9. “MARITAL STATUS AT TIME OF DEATH” - If the decedent was married at the time of death, then

married must be checked; if the decedent was widowed, then widowed must be checked. If the decedent was

registered in a domestic partnership with the State of Maine Registry, then domestic partner must be checked.

If never been married, check never married. If divorced, then check divorced.

10. “SURVIVING SPOUSE/PARTNER NAME” - If Marital Status is married, then Most Recent

Spouse/Partner must have Living checked with the name of the surviving spouse typed in (if female, give first

and maiden name). If Martial Status is widowed, then Most Recent Spouse/Partner must have deceased

checked with N/A entered into this box. If never married or divorced, then Most Recent Spouse/Partner need

only contain N/A. If Marital Status is domestic partner (must be a registered domestic partner in Maine), then

Most Recent Spouse/Partner must have Living checked with the name of the surviving domestic partner.

11. “FATHER’S NAME” (First, Middle, Last, Suffix) (DECEDENT’S FATHER’S NAME) - Either contains

data or N/A. If no middle name, then N/A should be entered. (If decedent was adopted, the legal parents are the

parents who adopted the child and must be entered on the death certificate, not the biological parents of the

decedent.)

12. “MOTHER’S NAME PRIOR TO FIRST MARRIAGE” (First, Middle, Last) DECEDENT’S MOTHER’S

NAME –Maiden name prior to first marriage. Either contains data or N/A. If no middle name, then N/A

should be entered. (If decedent was adopted, the legal parents are the parents who adopted the child and must be

entered on the death certificate, not the biological parents of the decedent.)

13a. “INFORMANT’S NAME” - Must contain the name of the informant. (This may have prearrangement or

Mortuary Trust written in, and may contain more than one name.)

13b. “RELATIONSHIP TO DECEDENT”

13c. “MAILING ADDRESS” (Street and Number, City, State, Zip Code) (INFORMANT’S ADDRESS) -

Must contain the address of the informant. (This may have prearrangement or Mortuary Trust written in. May

contain more than one name.)

14. “PLACE OF DEATH” (Check only one; see instructions) - If the decedent died in the Hospital, then

Inpatient, ER-outpatient or DOA must be checked. If the place of death was in a nursing home that must be

checked. If the death occurred at home - residence must be checked. If other, then other checked and a place

Death Page 16 of 37


must be entered e.g. boarding home or son’s home. If place of death is a boarding home, rehab center,

convalescent home then “Other” would be checked and the name of the type of facility completed in the blank

after the word Other.

This is medical certification information and can only be corrected or completed by the medical certifier who

certified the death on a SCOD.

15. “FACILITY NAME” (If not institution, give street & number) - If Hospital, the hospital name must be

entered, same for Nursing Home. If residence or other, then specific address must be listed e.g. 10 Common

Lane. (Post Office Boxes are not acceptable.)



16. “CITY OR TOWN, STATE, AND ZIP CODE” – The name of the city or town the death actually occurred

in.



17. “COUNTY OF DEATH” - Please be sure the correct county is listed.



18. “METHOD OF DISPOSITION”-A box must be checked off. (This should be what happens to the body

first.)

19a. “PLACE OF DISPOSITION” (Name of cemetery, crematory, or other place)

19b. “DATE OF DISPOSITION”

20. “LOCATION-CITY, TOWN, AND STATE” (of disposition)

21a. “NAME AND COMPLETE ADDRESS OF FUNERAL FACILITY” - Name and Address of Facility or

Authorized Person must contain a complete mailing address of the funeral establishment or the authorized

person.

21b. “FUNERAL ESTABLISHMENT LICENSE NUMBER” - N/A, if Authorized Person. This items must

contain data UNLESS it is an authorized person doing the removal, OR if it is an out of state funeral home

listed.

22. “SIGNATURE OF FUNERAL SERVICE LICENSEE OR OTHER AGENT” (SIGNATURE OF

FUNERAL PRACTITIONER OR AUTHORIZED PERSON) - Must be signed in black ink. This box must

contain a signature or rubber stamp signature; this cannot be an initialed signature. This items must contain

data UNLESS it is an authorized person doing the removal, OR if it is an out of state funeral home listed.

23. “LICENSE NUMBER (Of Licensee)” (LICENSE NUMBER AND ESTABLISHMENT LICENSE

NUMBER)- This items must contain data UNLESS it is an authorized person doing the removal, OR if it is an

out of state funeral home listed.

Death Page 17 of 37


ITEMS 24-25 MUST BE COMPLETED BY PERSON WHO CERTIFIES DEATH

Note: the medical certifier may only correct or complete all items from the Certifying Physician box to Other

Significant Conditions box.

24. “ACTUAL DATE OF DEATH” (Mo/Day/YYYY) -This should be typed or neatly hand printed. (with

month spelled out)


signed the death certificate.

25. “ACTUAL TIME OF DEATH” - Must contain a numeric entry.

26a. “WAS MEDICAL EXAMINER CONTACTED?”

26b. “MEDICAL EXAMINER CASE NUMBER” - Could contain a release number provided by the Medical

Examiner’s Office. This can remain blank.

CAUSE OF DEATH 27. PART I. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO

NOT enter terminal events such as cardiac arrest, respiratory arrest, or ventricular fibrillation without showing

the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary.

- Must contain a cause of death that does not state injury or trauma in it, i.e. hip fracture (this is an injury) or

Massive Head Trauma (trauma).

PART II. Enter other significant conditions contributing to death but not resulting in the underlying cause

given in PART I - May or may not contain data - if it does, again no injury or trauma listed in it.

28. “WAS AN AUTOPSY PERFORMED?” – This must be checked yes or no.

29. “WERE AUTOPSY FINDINGS AVAILABLE TO COMPLETE THE CAUSE OF DEATH?” - This must

be checked yes or no.

30. “DID TOBACCO USE CONTRIBUTE TO DEATH?” – select the appropriate box.

31. “IF FEMALE:” - pregnancy question – select the appropriate box.

32. “MANNER OF DEATH” select the appropriate box.

COMPLETED BY MEDICAL EXAMINERS ONLY: (Items 33-39)

33. “DATE OF INJURY”

34. “TIME OF INJURY”

35. “PLACE OF INJURY” (e.g., Decedent’s home; construction site; restaurant; wooded area)

36. “INJURY AT WORK?”

37. “LOCATION OF INJURY:” State: City or Town: Street & Number: Apartment No.: Zip Code:

Death Page 18 of 37


38. “DESCRIBE HOW INJURY OCCURRED:”

39. “IF TRANSPORTATION INJURY, SPECIFY:” – select the appropriate box.

COMPLETED BY ALL MEDICAL CERTIFIERS:

40. “CERTIFIER” (Check only one): Certifying Physician-To the best of my knowledge, death occurred due to

the cause(s) and manner stated. Or Medical Examiner-On the basis of examination, and/or investigation, in my

opinion, death occurred at the time, date, and place, and due to the cause(s) and manner stated. - This box must

contain a medical certifier’s signature in BLACK INK.

41. “NAME, ADDRESS, AND ZIP CODE OF PERSON COMPLETING CAUSE OF DEATH” (Item 27)

- Must contain a complete mailing address for the medical certifier.

42. “TITLE OF CERTIFIER”

43. “LICENSE NUMBER”

44. “DATE CERTIFIED” (Mo/Day/YYYY) (Spelled out – not numeric.) “DATE SIGNED”- This must

contain a date that is signed by the medical certifier.

45. “DECEDENT’S EDUCATION” -Check the box that best describes the highest degree or level of school

completed at the time of death.

46. “DECEDENT OF HISPANIC ORIGIN?” Check the box that best describes whether the decedent is

Spanish/Hispanic/Latino. Check the first box if decedent is not Spanish/Hispanic/Latino.

47. “DECEDENT’S RACE” (Check one or more races to indicate what the decedent considered himself or

herself to be) - This should contain data. This can be based upon the color of the decedent’s skin, or it can

have an entry such as Native American, Asian, and Indian etc.

48. “ANCESTRY” (French, English, etc., Specify) - This should contain data. American is acceptable, or N/A.

49. “DECEDENT’S USUAL OCCUPATION” (Indicate type of work done during most of working life. DO

NOT USE RETIRED.) This item should contain data or N/A. If the decedent is an infant, infant should be

typed here. If the decedent was a student, student should be typed here. (Disabled or Never Worked may be

entered.)

50. “KIND OF BUSINESS/INDUSTRY” - This should contain data or N/A.

MUNICIPAL CLERKS OR STATE REGISTRAR ONLY

51. “REGISTRAR’S SIGNATURE” - Complete this once the review is complete and the death certificate is

acceptable for filing. Sign all copies except the place permit issued copy. It should read, “Do not issue”.

52. “DATE FILED” (Mo/Day/YYYY) (Spelled out – not numeric.) Complete the date you accept the

certificate for filing on all copies.

Death Page 19 of 37


Incomplete Certifications

If the medical certifier needs laboratory or autopsy studies, etc., in order to adequately determine the cause of

death, he/she should enter “Pending” and add “Laboratory studies”, “autopsy”, etc., as appropriate, sign the

death certificate, and present it to the funeral director/funeral practitioner or authorized person for filing within

the required time frames. The death certificate should not be held incomplete while pending matters are

finalized except in unusual extenuating circumstances. Municipal Clerks should not hold any “pending”

death certificates. Once reviewed and accepted for filing, the original death certificate should

immediately be sent into the Vital Records office. Such “pending” death certificates are then finalized by

means of the Supplemental Cause of Death (SCOD) form furnished by the State Registrar or by the Medical

Examiner’s Office.

Presumptive Death

The Vital Records office registers deaths when the fact of death is established by the presence of a dead body.

Occasionally, persons are washed overboard at sea, or lost in other circumstances under which one might

reasonably conclude they are dead, but there is no body. Normally, the Vital Records office does not file a

death certificate if there is no body, but there are occasions where a death certificate is filed upon court order.

The presumption of death in these situations is a judicial issue involved in the distribution of the estate of the

person presumed dead. The Probate Court may hear evidence and may declare that the person is dead if the

evidence warrants, and may then proceed to probate the estate. Upon declaration of death from a Probate Court,

a death certificate may be created through the Office of the Chief Medical Examiner.

Refer persons who ask about death certificates in these cases to their attorney or to the Probate Court.

Death certificates must be filed with the Probate Court in the county where the death occurred (per Medical

Examiner’s Office and the Vital Records office, August 1999).

Death Occurring on Vessels or Aircraft on the High Seas

When a death occurs on the high seas, whether in an aircraft or on a vessel, the record is usually filed at the next

port of call. The distance from shore over three miles becomes International Waters.

Medical Examiner Cases

When death was due to an accident, violence, burns, fractures, falls, poisoning, suicide, or suspected homicide,

and in certain cases when the decedent was not under the care of a medical certifier, a medical examiner must

determine the cause and manner of death and complete the medical certification on the death certificate. The

death certificate must be completed and signed within 24 hours of the time the medical examiner was

notified of the death, unless the remains must be held longer for study or investigation. Details on the

causes, manner and circumstances may be left “pending” or “pending further study” if further study is

needed. In a medical examiner case, the body may not be embalmed, disposed of or removed from the State

until the medical examiner has completed the investigation and signed the death certificate or has given written

or verbal consent and a medical examiners release. These requirements are discussed further in the section of

Disposition of Human Remains.

Death Page 20 of 37


Specifically, the circumstances of death which require investigation by a medical examiner are as follows:

A death due to burns, fractures or falls.

A death due to violence or poisoning.

A sudden death of a person in apparent good health.

A death occurring during medical procedures indicating gross negligence or when due to trauma or

poisoning unrelated to the ordinary risks of the procedure.

A death that occurs in a mental health facility or nursing home not due to natural causes.

A death that occurs in police custody or when incarcerated in an institution and not due to natural

causes.

A death due to diseases, which are a threat to public health.

A death where there is reason to believe that the cause of death has not been properly certified.

A death due to Sudden Infant Death Syndrome and other deaths of children under 18 unless clearly

due to natural causes.

A death when the body is to be cremated.

Any person, who becomes aware of a death in circumstances that appear to require an investigation by a

medical examiner, must report the death to a medical examiner or law enforcement officer. In most

instances, referral of cases to medical examiners will be made by law enforcement officers, by medical

certifiers who are called to the scene of death, or by funeral directors/funeral practitioners who are usually

familiar with their reporting responsibility.

Occasionally municipal clerks will become aware through the filing of death certificates of situations where the

death has not been investigated by a medical examiner as required. Municipal Clerks should be alert for

problems of this nature and refer them to a medical examiner or law enforcement official or to the Office of the

Chief Medical Examiner. The phone number for the Office of the Chief Medical Examiner is 624-7180.

There are certain questionable circumstances in which the death must be reported to the Office of the

Chief Medical Examiner but need not be accepted by that Office for certification. In such cases, the Office

of the Chief Medical Examiner will refer the case back to the attending medical certifier (or appropriate

substitute) for certification. This provision has been in effect since July 1986. Examples of such cases are:

A death due to the consequences of long-term alcohol use.

A death due to long-term exposure to environmental or occupational toxins.

Death Page 21 of 37


A death due to long-term exposure to cancer-causing materials.

A sudden natural death of an elderly person who had not had previous specific symptoms or been

under treatment for the specific cause of death.

A death with any cervical injury recorded in the cause of death.

A no case assigned (Medical Examiner’s Release Number) by the Office of the Chief Medical

Examiner (Title 22 M.R.S.A. §2842 sub-§2-A effective September 13, 2003).

Disposition of Human Remains

Cremation

Cremation is final disposition and the ashes of a dead human body may be buried in a cemetery, scattered, or

otherwise disposed of with no further disposition permit. However, compliance with cemetery regulations for

burial must be met in order to bury cremains. Ashes may not be scattered over populated land areas from an

airplane or scattered in Baxter State Park.

Fetal Remains

The disposition of fetal remains, regardless of the length of gestation, is subject to the same laws and

regulations as dead bodies if they are buried in a cemetery, cremated, buried at sea, used by medical

science, or removed from the State. Embryonic tissue and fetuses delivered in a hospital or facility may be

disposed of by arrangement between the parents and the hospital without a Disposition Permit if the hospital has

suitable facilities. Please refer to the section of this Handbook on Abortions and Fetal Deaths for discussion of

the disposition of fetal remains.

Medical Examiner’s Release

Before final disposition of a body may be made in a manner which will prevent further examination or judicial

inquiry, a release must be obtained from a medical examiner, whether the death was a medical examiner case or

not. Methods of disposition requiring a release include cremation, burial at sea, use by medical science,

and removal from the State. The Medical Examiners Release (see the VS37) is described in a subsequent

section; it is required in addition to the Permit for Disposition of Human Remains (see the VS35) and the death

certificate (see the 2012 legal size death certificate) or Report of Death (see the VS36). These forms are

available on the restricted access website.

Medical Examiner’s Release Form

The Medical Examiners Release Form VS-37 is a single page form (available on the restricted access website)

from which a photocopy is made for filing. The crematorium, medical school, or other facility of final

disposition retains a signed copy of the release. A photocopy is retained by the municipal clerk who issues

the Disposition Permit as documentation that release of the human remains was obtained prior to final

disposition by irreversible means such as cremation, burial at sea, use by medical science; or removal

Death Page 22 of 37


from the State. The Medical Examiners Release is required before the remains can be removed from the State

by anyone, including a Maine licensed funeral director/funeral practitioner.

Forms are available on the municipal clerks restricted access page of the Data, Research and Vital Statistics

website at www.maine.gov .

Please apply for your user name and password online.

Forms Discussed in this section:

VS37 - MEDICAL EXAMINER’S RELEASE FORM

SUB-REGISTRARS

The municipal clerk may appoint one or more sub-registrars in your municipality who are authorized to issue

Permits for Disposition of Human Remains (Disposition Permits). These sub-registrars must be appointed in

writing, sworn in, and the appointment recorded in your office. Sub-registrars operate under your authority

and serve at your convenience. You may rescind appointments at any time for any reason. You may use a form

similar to Exhibit on page 23, for a written appointment.

Your sub-registrar appointments expire when your term expires, and you must reappoint them at the

beginning of each new term if they are to continue. Notify a sub-registrar in writing when his/her

appointment is rescinded or when he/she will not be reappointed. Sub-registrars issue Disposition Permits

under the same conditions and are bound by the same laws and regulations as municipal clerks, with an

exception to issuing Disposition Permits for disinterment.

Sub-registrars must receive a completed death certificate or report of death before issuing a

Disposition Permit.

Sub-registrars must receive a Medical Examiners Release if applicable for the type of disposition.

Like the municipal clerk who appointed him or her, a sub-registrar may issue a Disposition Permit

only if the death occurred in the municipality in which he/she has already been appointed,

or if an establishment of the funeral director/funeral practitioner having custody of the body is

located in the municipality.

Sub-registrars must report the issuance of Disposition Permits to the municipal clerk who

appointed them, at the earliest opening of the municipal office after the date of issue, or within 6

days at the latest. At this time, the sub-registrar must transmit a copy of each Disposition Permit

issued together with a copy of the completed Death Certificate or Report of Death, and Medical

Examiners Release if applicable.

A person who has been appointed as a sub-registrar may not be designated as an “official of the municipality”

for the purpose of endorsing the Disposition Permits for burials or disinterment, which take place within the

municipality.

Municipal Clerks must exercise appropriate control over the activities of sub-registrars and may impose

such restrictions on them, as they feel necessary. Willful refusal or negligent failure to observe laws and

regulations or follow instructions, which you have issued, is sufficient cause to rescind an appointment.

http://www.maine.gov/

Death Page 23 of 37


There may be other penalties as well, for neglect or violation of the laws and regulations, as discussed in

the Handbook section on Penalties.





SUB-REGISTRAR COMMISSION

Exhibit

MUNICIPAL LETTERHEAD

TO: (Name of Sub-registrar)

You are hereby appointed as Sub-registrar for the (name of municipality). As Sub-registrar, you are

authorized to issue Permits for Disposition of Human Remains (Disposition Permit) in the case of deaths

which occur in the (name of municipality) subject to the provisions of 22 MRSA §2843 and §2844.

This appointment is made with the following provision: you may issue Disposition Permits only

when the municipal office is closed or the municipal clerk or deputy clerk is not available. In such

case, you must report your issuance at the earliest opening of the municipal office.

Sub-registrars serve under the authority and at the contentment of the Municipal Clerk who appoints

them. This appointment may be terminated at any time by written notice and in any event shall cease at

the end of the term of the undersigned as Municipal Clerk.

Signature:

Municipal Clerk of

(Name of Municipality)

Date:

MUNICIPAL SEAL


Death Page 24 of 37


Permit for Disposition of Human Remains

Human remains must be disposed of within a reasonable time after death or transportation into the State.

Human Remains may be disposed of by:

Burial in a cemetery

Placement in a vault (temporary storage)

A tomb or mausoleum

Cremation

Burial at sea

Use by Medical Science

Removal from State (Transportation out of state for final disposition in another state or foreign

country)

The funeral director/funeral practitioner or authorized person in charge of the final disposition or transportation

from the State must comply with the Permit for Disposition of Human Remains (Disposition Permit)

requirements and MUST obtain a signed Medical Examiners Release form in certain circumstances. The

statutes and rules, which govern procedures for the disposition of human remains, are included in the Digest of

Laws and Regulations (see 10-146 CMR 1. Transportation, Storage and Final Disposition of Dead Bodies).

A Permit for Disposition of Human Remains (Disposition Permit), Form VS-35, is needed for:

Transportation

Storage

Final disposition of human remains

The following persons are authorized to issue the Disposition of Human Remains:

The municipal clerk of the place of death.

The municipal clerk of the municipality where the business establishment is located.

(If a Maine Licensed funeral director/funeral practitioner)

Sub-registrars of either municipality.

The municipal clerk may appoint one or more sub-registrars to assist in this function.

The Disposition Permit and associated forms underwent some changes on September of 2010 and will be again

later in 2012.

Those responsible for final disposition of human remains or for transportation of human remains out of the State

must obtain a Permit for Disposition of Human Remains (Disposition Permit) prior to such action. A

Disposition Permit issued by the municipal clerk at the place of death or where the establishment of the funeral

Death Page 25 of 37


director/funeral practitioner is located (in Maine) or by the proper authority in another state of foreign country

where the death occurred authorizes burial or temporary storage in any cemetery in the State. A Medical

Examiner’s Release authorizes cremation, burial at sea, use by medical science, or transportation of the body

outside of the State for final disposition elsewhere when accompanied with a Disposition Permit.

The Disposition Permit has three principal purposes:

To ensure that death certificates are properly filed.

To notify persons in charge of cemeteries, crematories, or other places of final disposition that all

requirements of law have been fulfilled and they may bury, cremate, or entomb a body.

To record the actual place and date of final disposition.

A funeral director/funeral practitioner may obtain the Disposition Permit (upon payment of the issuing fee)

from the municipal clerk of the municipal office where their establishment is located rather than from the

municipal clerk where the death occurs. The funeral director/funeral practitioner is responsible for filing

the completed death certificate in the municipal office where the death occurred within five (5) days after

the death.

A funeral director/funeral practitioner applying for a Disposition Permit must present a completed death

certificate and the required issuing fee. If a completed death certificate is not available to the funeral

director/funeral practitioner in time to meet the schedule for burial because of reasons beyond his/her control,

he/she may file a Report of Death, Form VS-36 in lieu of a death certificate. This is discussed in more detail

later on in the section on “Report of Death”. Authorized persons, (anyone who is not a Maine funeral

director/funeral practitioner), must file a death certificate that is complete in all respects, and indicates that the

medical certifier or medical examiner personally examined the body after death. Authorized persons may not

use the Report of Death Form.

A Disposition Permit is required for relocation of a body within the same cemetery.

Permit for Disposition of Human Remains Form

The Permit for Disposition of Human Remains (Disposition Permit), Form VS-35 was revised in September of

2010 and will be reviewed again later in 2012. The form is a single page rather than a multi-copy. The funeral

director/funeral practitioner makes photocopies from the original Disposition Permit for filing at the place of

death, and place Disposition Permit issued; an additional copy is made for retention at the place the disposition

permit is issued until a copy fully endorsed by the appropriate cemetery official is returned to the municipal

clerk who issued the Disposition Permit.

Copies must be on regular photocopy (20 LB) white paper to ensure preservation. The Original Disposition

Permit is filed in the municipality where the human remains are disposed.

Funeral directors/funeral practitioners may print their own Permit for Disposition of Human Remains

(Disposition Permit) using software customized for the Maine Disposition Permit and a laser or ink-jet printer.

The Vital Records office must approve both the format of the forms (this must correspond to state forms

exactly).

Death Page 26 of 37


Cheat Sheet:

- The place of death and the place the permit issued (if different) on the Disposition Permit are due a

$20.00 issuing fee.

- The issuing clerk or sub-registrar cannot sign as person in charge of final disposition on the

Disposition Permit unless the remains were placed in temporary storage and the funeral

director/funeral practitioner owns the storage facility specified.

- Signature of Issuing Clerk or Signature of Sub-registrar cannot be the same as the Signature of

Person in Charge, Municipal Official, Funeral Director/Funeral Practitioner, or Other Authorized

Person box except if a funeral director/funeral practitioner owns the storage facility.

- The place of death municipality, the place the permit issued municipality and/or the State, and

place of final disposition municipality are where the Disposition Permit is to be filed.

- Place of Death, City or Town of Issuance or Municipality of Sub-registrar and Location of

Cemetery, Crematory, Medical School, or Other Destination are the municipalities where the

Disposition Permit is filed.

Deaths at the United States Department of Veteran’s Affairs formerly known as Togus are filed at

the Vital Records office or filed by a Sub-Registrar of the State are required to file Disposition

Permits and pay a $25.00 issuing fee directly with the Data, Research and Vital Statistics office in

Augusta.





VS35 - PERMIT FOR DISPOSITION OF HUMAN REMAINS FORM

Procedures for Using the Permit for Disposition of Human Remains

Photocopies are made from the Original Permit for Disposition of Human Remains (Disposition Permit) for

distribution to the following municipalities:

Place of Death

Place Permit Issued

Issuing Clerk-Retain Until Endorsement Received

The photocopies are made by the funeral director/funeral practitioner and presented to the municipal clerk or

sub-registrar who will issue the Disposition Permit. They may also be made by the municipal clerk if they are

the person issuing the Disposition Permit.


Death Page 27 of 37


1. The funeral director/funeral practitioner marks the check boxes at the top of each Disposition Permit

to designate them as “Place of Final Disposition”, “Place of Death”, “Place Permit Issued, and

“Issuing Clerk- Retain Until Endorsement Received” after the photocopies are made.

2. The funeral director/funeral practitioner presents all copies of the Disposition Permit to the

municipal clerk or sub-registrar at the place of death or the municipality where the funeral

establishments business is located, for approval and issuance of the Disposition Permit. If the

Disposition Permit is issued at the place of business, an Issuing Permit fee is paid to the

municipality upon issuance.

3. The municipal clerk or sub-registrar reviews the Disposition Permit for accuracy and determines the

completeness of the supporting documentation before granting permission for disposition by signing

all copies of the Disposition Permit. The Disposition Permit is not valid until the municipal clerk or

sub-registrar has signed it.

4. The issuing municipal clerk keeps the copy “Issuing Clerk-Retain Until Endorsement Received”

until the endorsed copy is returned.

5. Disposition Permits are endorsed and distributed to the municipal clerks at the place of final

disposition, place of death, and place permit issued, as specified in subsequent sections.

Type of Disposition Permit

The Disposition Permit may be issued for different actions related to the transportation, storage, disposition or

other handling of human remains. The type of action authorized by the action is indicated in the Permission

Requested For box:

Temporary Storage - Burial – Disinterment – Cremation -Entombment

Removal from State - Burial at Sea - Use by Medical Science (or Autopsy)

The Permit for Disposition of Human Remains (Disposition Permit) is valid only for the action indicated in

“Permission Requested For” box. If another means of disposition is decided upon subsequently, a new

Disposition Permit must be obtained. The only exception to this is “Temporary Storage” which should

always be accompanied by an action for final disposition. Changes in the place or date of final disposition

do not require a new Disposition Permit; the actual place and date should be entered in the appropriate

section in the lower half of the Disposition Permit.

Certain actions require additional certificates, permits, releases or authorizations in addition to the Disposition

Permit itself, as listed below. In the “Authorization for Permit” section, municipal clerks or sub-registrars

should record the other documents which must be presented as part of the request for a Disposition Permit.

Municipal Clerks or sub-registrars must receive all other required documents before issuing the Disposition

Permit for the specified action.

Death Page 28 of 37


Authorization for Disposition Permit

Type of Action

Permitted

Documents Required for Authorization of Permit

Death Report of Medical Application

Certificate Death (b) Examiner’s for

Release Disinterment

Transport (a)

Temporary Storage

Burial

Cremation

Entombment

Removal from State

Burial at Sea

Use by Medical Science

(Autopsy)

Disinterment

X

X (X)

X (X)

X X

X (X)

X (X) X

X X

X X

X

Notes:

(a) A funeral director/funeral practitioner licensed to practice in Maine may transport a body from the

place of death to his/her establishment(s) without a permit or other documentation.

(b) The Report of Death is for funeral directors/funeral practitioners only. An authorized person other than

a Maine licensed funeral director must present a signed death certificate in order to receive a Disposition Permit

for any type of action.

Endorsement

Upon final disposition of the body, the Permit for Disposition of Human Remains (Disposition Permit) is

completed and endorsed by the person in charge of the cemetery or crematory, or by the funeral director/funeral

practitioner or authorized person if disposition is by burial at sea, use by medical science or removal from the

State.

If there are any cemeteries located in your municipality, which do not have a sexton or other specific

individual in charge of them, you, the municipal clerk, must endorse the Disposition Permit for each

burial or disinterment, which takes place in such cemeteries. If you are not a full-time municipal clerk,

you may designate another elected or appointed municipal official to perform this function in your

absence. Such designation must be in writing; an example of written designation is shown on page 28. However, a person you have appointed as sub-registrar may not also be designated as the municipal official

with this responsibility.

Endorsement signatures on the Disposition Permit (item 18) cannot be the same signature as appears as

the issuing signature (item 10 or 11). This is a conflict of interest for item 10 or 11 and 18 to contain the

same signature unless the funeral director/funeral practitioner owns the storage facility (see Digest of

Laws and Regulations 10-146 CMR 1. Transportation, Storage and Final Disposition of Dead Bodies).

Death Page 29 of 37






EXAMPLE: DESIGNATION OF MUNICIPAL OFFICIAL TO ENDORSE DISPOSITION

PERMITS FOR BURIAL IN MUNICIPALITY

Exhibit

(MUNICIPAL LETTERHEAD)

To: (Name of Municipal Official)

You are hereby designated as a municipal official who may endorse the Permit for Disposition of

Human Remains pertaining to any burial, which takes place in the (name of municipality) in a cemetery

having no person in charge of it, pursuant to 22 M.R.S.A. §2843.

This designation may be terminated at any time by written notice and in any event shall cease at the end

of the term of the undersigned as municipal clerk.

_______________________________

(Signature)

_______________________________

Municipal Clerk of (Name of Municipality)

Date

(MUNICIPAL SEAL)


Death Page 30 of 37


Retention and Filing of the Permit ffoorr DDiissppoossiittiioonn of Human Remains (Disposition

Permit) After Endorsement

The original Disposition Permit is filed with the municipal clerk at the place of final disposition. The person in

charge of the cemetery/crematory files this, unless no one is available; then, the funeral director/funeral

practitioner is responsible for filing.

Copy 1

The funeral director/funeral practitioner or authorized person files this copy with the municipal clerk

at the place of death. If the Disposition Permit was not issued at the place of death, a Disposition Permit

issuing fee must be paid at this time.

Copy 2

Is filed with the issuing municipal clerk by the funeral director/funeral practitioner or authorized

person, to be matched with Copy 3.

Copy 3

Is retained by the issuing municipal clerk until endorsement is received. Upon receiving the endorsed

copy of the Disposition Permit, Copy 3 may be destroyed.

All endorsed Disposition Permits that you receive as the place of final disposition, the place of death, or

the place of issuance, must be retained as permanent records. They are open to public inspection, and

therefore, should be kept in separate books/files for filing.

The municipal clerk needs only to retain the original place of final disposition of the Disposition Permit if only

one municipality is involved in the burial process (place of death, final disposition, and place of issuance).

Death Certificate Delays

The law (Title 22 M.R.S.A. §2842) requires prompt completion of death certificates so that they may be

registered before the body is buried. There are occasions, however, when this cannot be done – usually because

the medical certifier or medical examiner is unable or unwilling to complete the medical certification promptly.

When the cause of death cannot be determined until autopsy results become available, the medical

certifier may, if satisfied that death is due to natural causes, complete as much of the cause of death

section as possible and indicate that autopsy results are pending. The death certificate may then be filed

and a Permit for Disposition of Human Remains issued; the Vital Records office will query the medical certifier

for information to complete the death certificate.

In some cases, a funeral director/funeral practitioner may use a Report of Death when he/she is unable to obtain

a signed death certificate from the medical certifier before the body is buried or removed from the state. This is

covered in the next section.

Delays in preparation of death certificates need not result in delays in burial unless a medical examiner or law

enforcement authorities require additional time to complete an investigation.

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When there are chronic problems with delays in filing death certificates, you may notify the Vital

Records office. We will work with funeral directors/funeral practitioners and medical certifiers who are

chronically delinquent in filing death certificates in order to obtain better reporting and notify the

appropriate board of licensure or registration when necessary.

Report of Death

When the funeral director/funeral practitioner makes a reasonable effort to obtain a completed death

certificate, but cannot do so in time for burial, and there is no other reason to delay the burial, the

funeral director/funeral practitioner may file a Report of Death and a Permit for Disposition of Human

Remains (Disposition Permit) may be issued. The funeral director/funeral practitioner completes the Report

of Death, Form VS-36, which identifies the deceased and names the attending medical certifier. The Report of

Death also contains a statement by the funeral director/funeral practitioner that he/she has personally contacted

the attending medical certifier and has been assured that the attending medical certifier will certify the death as

due to natural causes. If a medical examiner has been contacted, the Report of Death must name the medical

examiner and include the same assurances that the medical examiner has been personally contacted and

indicated that the body may be released for final disposition for burial. The Report of Death may not be used by

anyone other than a Maine licensed funeral director/funeral practitioner.

The Report of Death is now a single page form, with a photocopy (on 20 lb. regular photocopy paper) made and

signed by the funeral director/funeral practitioner before it is presented to you. The checkboxes at the top

should be marked to designate the destination of each copy. The municipal clerk who issues the Disposition

Permit retains one signed copy of the Report of Death form. The original is filed at the place of death, if

different.

Purpose of the Report of Death

A Report of Death form must be filled out by a funeral director/funeral practitioner who is requesting a Permit

for Disposition of Human Remains if he/she does not have a completed death certificate to present to you. This

form gives the funeral director/funeral practitioner an additional 21 days to obtain a signed death

certificate to file. The Report of Death form will also keep you, the municipal clerks, alert to the fact that a

death certificate is outstanding. You may check with the funeral director/funeral practitioner involved if it is

not received within the allotted time.

If the death certificate is completed and received by you within three weeks, you may destroy the Report of

Death form you are holding. When 21 days have elapsed with no death certificate having been filed in your

office, the Vital Records office should be notified so we can investigate and determine where the problem

exists.

The purpose of the Report of Death form is two-fold:

It allows the Disposition Permit to be issued in emergency cases where it is not possible to obtain a

completed death certificate in time for burial or removal from the State, and

It serves as a means of pinpointing trouble spots, so that appropriate action can be taken to clear up

difficulties now present.

Death Page 32 of 37


There are a number of death certificates which are not properly filed each year, but the Vital Records office is

not aware of these missing death certificates until one is requested and we do not have it on file. There is a lot

of detective work involved in finding the information needed to file late death certificates.

When you, as municipal clerk, have named a sub-registrar within the municipality, you should instruct the

sub-registrar to turn over all Reports of Death to you so that you are aware that a death certificate has

not been filed. The Vital Records office cannot assist you with contacting doctors or funeral directors/funeral

practitioners that are delinquent in performing their duties without your assistance in knowing who to contact

from the information contained in the Report of Death.





VS36 - REPORT OF DEATH

Communicable Diseases

When death was due to an acute communicable disease, you should consult the Municipal Health Officer before

issuing a Disposition Permit to an authorized person.

Dead bodies are not usually a public health problem, but in the case of certain communicable diseases,

regulations of the Department of Health and Human Services forbid public funerals. In other instances, the

Health Officer may wish to instruct the individuals on how to protect themselves while handling the body.

Funeral directors/funeral practitioners are trained and experienced in this area, but most other people are not.

Transportation of Human Remains

Only licensed funeral directors/funeral practitioners and ambulance/rescue units may carry dead bodies

without a Disposition Permit. No one may carry a body out of the State or into the State without a Disposition

Permit. Authorized persons with a Disposition Permit may carry bodies in private vehicles. When they do so,

they must use an enclosed vehicle and conceal the body from public view. The body must be in a casket, box,

or body bag for transportation.

Regulations of the Department of Health and Human Services further require that if the body is to be shipped on

a common carrier (railroad, commercial airline, motor freight service, etc.), it must be embalmed and placed in

a sound casket, which is enclosed in a strong outside shipping case. If the body cannot be embalmed, it must be

enclosed in a container, which is airtight and water tight so as to prevent the escape of fluids or odors.

Issuing Disposition of Human Remains Permits for an Authorized Person

When the municipal clerk is satisfied that an individual other than a Maine-licensed funeral director/funeral

practitioner has proper authorization, and a completed death certificate is presented indicating that the medical

certifier personally examined the body after death, you may issue a Disposition of Human Remains Permit

(Disposition Permit). A Disposition Permit may not be issued to anyone other than a Maine licensed funeral

director/funeral practitioner until both of these conditions are met.


Death Page 33 of 37


If the Disposition Permit is issued for cremation, burial at sea, use by medical science, or removal from the

State, a Medical Examiner’s Release form (VS-37) must be presented to the municipal clerk before the

Disposition Permit may be issued. Specifically, you should not issue a Disposition Permit for cremation on

the assumption that the Medical Examiner’s Release will be provided later by the crematorium operator.

Disposition by Authorized Person

Individuals who are not Maine-licensed funeral directors/funeral practitioner are permitted to bury or make

arrangements for final disposition of human remains in Maine. The law (Title 22 §2846 see Digest of Laws &

Regulations) refers to these as “authorized persons” and specifies who they may be. In disposing of human

remains, authorized persons are subject to all laws and regulations, which relate to burial or other final

disposition and transportation of human remains.

Maine M.R.S.A. Title 22 §2846 defines “Authorized Persons” as follows:

Members of the immediate family. This means a parent, spouse, brother, sister or child of the

deceased.

Domestic partner of the deceased.

A person authorized in writing by a member of the immediate family of the deceased if no member of

immediate family of the deceased wishes to assume the responsibility or by the domestic partner of

the deceased if the domestic partner does not wish to assume the responsibility or, in the absence of

immediate family or a known domestic partner.

A funeral director/funeral practitioner from another state or country who is not licensed in the State of

Maine may handle disposition of a person who died in Maine only as an authorized person. This

means that he/she must present authorization in writing from the family as well as a signed death

certificate and a Medical Examiner’s Release prior to transporting or disposing of the human remains

or removing the human remains from the State.

Disposition of human remains that do not follow the normal process, should be referred to the Vital

Records office for clarification of procedures.

Authorized persons who are not funeral directors/funeral practitioner cannot accept money for their services.

The acceptance of money may constitute the practice of funeral service without a license (Title 32 M.R.S.A.).

Enforcement

It is not the responsibility of municipal clerks to enforce funeral service licensing laws. You need only to

satisfy yourself that the person who presents himself or herself as an authorized person has proper authorization

under the law, i.e., either is a member of the immediate family of the deceased, has written authorization from a

member of the immediate family or is a domestic partner of the deceased. However, if you have reason to

believe that an individual may actually be practicing funeral service, because of repeated incidents or some

other reason, please notify the Board of Funeral Service at the following address:

Death Page 34 of 37


Board of Funeral Service

Department of Professional and Financial Regulation

35 State House Station

Augusta, Maine 04333-0035

Disinterment

After a body has been buried, it may not be removed from its tomb or grave except for a good reason (Title 22

§2843 sub-§2).

A body may be exhumed on order of the Superior Court when the Court finds that examination of the body is

necessary.

A body may be disinterred upon order of the Superior Court when the Court finds that the body has been

interred in an improper or unauthorized cemetery, vault, or other burial structure and that it must be re-interred

elsewhere.

A body may be disinterred for re-interment elsewhere when all of the interested parties are in agreement with

this action or the disinterment is authorized by the Superior Court. The interested parties who should agree to

the move include

-The next of kin, including the surviving spouse or domestic partner,

-The proprietor of the cemetery, and

-The owner of the lot where the body is buried.

Disinterment of Cremains

The State of Maine does not regulate disposition of cremains, therefore no Permit for Disposition of Human

Remains is required for removal of cremains. Documentation at the cemetery level MUST be accounted in

compliance with all cemetery regulations, which include notifying sextons of cemeteries.

Disposition of Human Remains Permit for Disinterment

Before any body is disinterred, the funeral director/funeral practitioner in charge of the disinterment must apply

to the municipal clerk of the municipality where the body is buried for a Permit for Disposition of Human

Remains (Disposition Permit). No Disposition Permit is necessary when the Superior Court has issued an order

to exhume a body. Sub-Registrars cannot issue the Disposition Permit for disinterment.

When you are called upon to issue a Disposition Permit for disinterment, you must satisfy yourself that the

person requesting the Disposition Permit has the necessary authorizations for the disinterment. This would

include an Application for Disinterment, Form VS-38. This is an affidavit signed by the next of kin that all

family members have been queried and that there are no impediments to the disinterment. There are penalties

for the applicant if it subsequently appears that it is false. In addition, there may be court action by other

members of the family if they are in disagreement, but any such action would not involve you or your

municipality. When you are satisfied that all necessary items are in order, you may issue the Disposition Permit

Death Page 35 of 37


for disinterment on a regular Disposition Permit form, marking the “Disinterment” indication in “Permit

Requested For”.

Conduct of Disinterment

A funeral director/funeral practitioner must be in charge of the disinterment except for bodies exhumed on order

of the Superior Court. The funeral director/funeral practitioner is responsible for obtaining the Disposition

Permit for disinterment, for making all arrangements for the proper conduct of the disinterment, and for the

removal and disposition of the body at its new resting place.

The person in charge of the cemetery where the disinterment takes place is responsible for requiring a

disposition permit before allowing the disinterment to proceed and for proper conduct of the excavation and

removal of the body from the grave.

Transportation of Disinterred Bodies

Disinterred bodies must be enclosed for transportation in a container, which will prevent the escape of fluids or

offensive odors.




Forms Discussed in this section: VS38 - APPLICATION FOR DISINTERMENT OR REMOVAL

Temporary Storage

There are occasions when it is necessary to place a body in temporary storage for a period of time before the

burial. An example of this is storage during the winter months for burial in the spring. When the storage is to

be for more than 14 days, the person in charge of the disposition must request a Disposition Permit for

the purpose of temporary storage. The funeral director/funeral practitioner will obtain endorsement from the

person in charge of the storage facility, usually a vault, but retain all three copies of the Disposition Permit until

such time as final disposition is completed.

Bodies may be stored up to eight months in temporary storage without further paperwork. Storage for

any period of time longer than eight months is considered final disposition and removal is regarded as

disinterment. When this occurs, a new Disposition Permit is required to complete disposition of the body.

Private Burying Grounds

Those persons wishing to do so may establish a family burying ground by setting aside a piece of land no

larger than ¼ acre, fencing it or marking the boundaries in some permanent manner, and recording a

description with the municipal clerk of the municipality where it is located and/or with the Registrar of


Death Page 36 of 37


Deeds. It is recommended to record it with both since a burying ground is set aside forever once a body is

buried and it cannot be conveyed when the land around it is sold.

Private burying grounds are subject to the same restrictions as other cemeteries and cannot be located within

100 ft. of a neighbor’s house or 200 feet of their well if the neighbor protests in writing. Persons wishing to

establish a family burying ground would be well advised to consult with neighbors and with municipal officials

concerning local ordinances.

If additional information is need, contact the Division of Environmental Health at 287-5695. The Maine

Cemetery Association may be contacted for information on requirements for burial grounds at 1-800-585-6589.

Private burial grounds are regulated by the same requirements as any public burial grounds.

Errors on Death Certificates

ONLY THE FUNERAL DIRECTOR/FUNERAL PRACTITIONER; AUTHORIZED PERSON or the

INFORMANT listed on the record may apply to correct the personal information on a death certificate by

using the VS-7 form.

If an error is found on a death record and it has been less than 90 days since the date of filing, the

applicant may correct the error by completing the VS-7 and having their signature notarized on the front

of the VS-7. There is no fee and no other documentation is required.

If the error is found 90 days or more after the date of filing, the fee to correct the record is $60.00 and

two forms of supporting documentation are required.

To complete the name of a decedent: The authorized person, the funeral director/funeral

practitioner, or the informant listed on the record, may apply to complete the decedents name. Two

(2) supporting documents must be submitted when applying for a completion regardless of how

long the record has been on file. There is no fee when applying within 90 days from the date of

filing; however, there is a $60.00 fee when completing a record that has been filed for more than 90

days.

A list of sample documentation that may be used when applying to correct a death certificate can be

viewed more in the AMENDMENT SECTION of the department rules10-146 Chapter 2.

If there is an error in medical information; cause of death, only the MEDICAL CERTIFIER that signed the

document may apply to correct the error. They may do so by completing a Supplemental Certificate of Death

(SCOD) available by calling the DRVS at 1-888-664-9491 or downloading it from the medical certifiers

restricted access page.

Certificate of Abandonment: Maine Public Law, Chapter 387, LD 1490, effective September 2011.

Chapter 64 contains new language regarding custody and control of the remains of deceased persons that pertain

mostly to funeral directors/funeral practitioners and who may have custody and control of a deceased person.

The following are the changes funeral directors need to be aware of:

Death Page 37 of 37


If a person who has the right of custody and control does not exercise the rights and responsibilities of

custody and control within 4 days after the death of the subject, custody and control belong to a person

from the next lower level of priority established in Title 22 M.R.S.A. §2843-A sub 2 sub A through sub

C.

A person who has been charged with murder or manslaughter forfeits the right of custody and control

provided under this subsection; and a funeral director or practitioner of funeral service who is aware of

the charges may not release the remains or a dead body to that person who has been charged with

murder or manslaughter. If the charges against the person are dismissed or the person is acquitted of the

charges before the final disposition takes place, the person regains the right of custody and control in the

same position of priority established in this subsection.

Title 22 M.R.S.A. §2843-A, sub-§10 is new and states:

o If there is a dispute regarding custody and control, a funeral director or practitioner of funeral

service may refuse to accept the remains or dead body, inter or otherwise dispose of the remains

or dead body or complete funeral arrangements until the funeral director or practitioner of

funeral service is provided with a court order under subsection 4 or a written agreement of the

person who has custody and control,

o If there is a dispute regarding custody and control, pending a court determination under

subsection 4 a funeral director or practitioner of funeral service who has physical possession of

the remains or a dead body may embalm or refrigerate and shelter the remains or a dead body

and may bill the estate of the subject for those costs, plus attorney’s fees and court costs.

o A funeral director or practitioner of funeral service, cemetery or crematory may rely on a

statement of funeral goods and services, cremation authorization form or other authorization

signed by a person who has custody and control of the remains or a dead body and may carry out

the instructions provided for in the statement of funeral goods and services or on the form or

authorization unless the funeral director or practitioner of funeral service, cemetery or crematory

knows of objections from another person.

o A funeral director or practitioner of funeral service, cemetery or crematory is not required to

independently investigate custody of the remains or a dead body or who is next of kin.

Title 22 M.R.S.A. §2843-A, sub-§2 section C – regards custody and control of an abandoned dead body.

Specifically, the remains or a dead body is considered abandoned if no one takes custody and control of the

remains or dead body for a period of 15 days. A funeral director or practitioner of funeral service who has

physical possession of abandoned remains or an abandoned dead body may bury the remains or dead body. The

funeral director or practitioner of funeral service may embalm or refrigerate abandoned remains or an

abandoned dead body without authorization. A certificate of abandonment that indicates the means of

disposition must be filed in the municipality where the death occurred.

The policy on the Certificate of Abandonment is that this is a public document (similar to the Disposition of

Human Remains Permit) and will be filed with the Disposition of Human Remains Permit in the municipality of

death.

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