Under 1 Year

Under 1 Day

The information above was reviewed and found to be correct. I attest that all information is accurate and truthful. I understand that it is a felony willfully or intentionally supply false information.

Signature of Informant Required

Date Required

The collection and reporting to DHEC of information contained on the South Carolina Death Certificate are exempt from HIPAA regulations (see 45 CFR 160.203 (c). 164.512(b)(1) However, state law provides protection against the unauthorized release of confidential information from the death certificate.

Surviving Relatives

Biological Information