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Translation into Polish

Hi there, is there anybody who could translate me a short text into Polish? I’d like to write to a civil registry office for the records of my great-grand-father in Poland. But, I don’t know any Polish. Thanks.

Here is the text:

Dear Sir or Madam,

I´m searching for the death record of my great-grand-father who died in Płakowice between 1903 to 1910. His surname was Kulzynski or Kulczynski and his Christian name was probably Johann. Could you help me, please, to find out his date of death or rather to find out his record?