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Application To Correct Factual Errors [Section 27 (3)] In The Death Certificate (Peninsular)

Reason For Application

Application to insert information or correct any factual errors provided during registration due to incorrect or unavailable information.

Application Condition

Application for registration of death may be made by the following persons:

  1. Parent of the deceased;
  2. Spouse of the deceased;
  3. Sibling of the deceased;
  4. Child or legally adopted child of the deceased
Required Documents


  1. Form JPN.LM21 that is completed;
  2. Form JPN.LM22;
  3. Death Certificate of the deceased (original and copy);
  4. Identity card or identification document of the applicant (original and copy);
  5. Marriage certificate or document if application is made by the spouse;
  6. Other supporting documents such as the certificate or card certifying embracing of Islam of a parent of the deceased, Birth or Death Certificate of a parent of the deceased and the letter of approval for change of name from the Identity Card Division of NRD

Application fee: RM50.00
Extract Fee Death Certificate: RM5.00

Applications Form
  1. JPN.LM21 
  2. Akuan Sumpah AM 80 

    Note : The online forms are to be used reference only.The may not be printed and used for transaction purpose.For transactions,please use the original forms.

Ibu Pejabat Jabatan Pendaftaran Negara Putrajaya, 
No 20, Persiaran Perdana, Presint 2,
Pusat Pentadbiran Kerajaan Persekutuan,
62551 Wilayah Persekutuan Putrajaya. 

Telefon: 03-8000 8000  Faks: 03-8880 8288 
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