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Your Parish Coroner’s Office

1234 Main St
Your Town, La. 70739
(225)123-4567

Date: January 01, 2019

Re: Joan Doe SSN: 123-45-6789

This Fact of Death Letter is issued in accordance with Louisiana Revised Statute
13:5713 G (2). This statute states that this letter shall serve in lieu of a Death Certificate
constituting proof of death for all purposes, including but not limited to any claim under any
policy of insurance issued on the life of the deceased individual.

This letter attests to the Fact of Death of Joan Doe, whose date of birth is 08/02/1934, who died
on 12/31/2018 at 9191 State Hwy 95 in the Parish of YOUR PARISH HERE.

Regards,

______________________________________
Your Coroner’s Name
Your Parish Coroner’s Office

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