Birth Certificates | Vital Records

required fields ^*

STEP 1: Birth Certificate Order

Who are you ordering for? My Birth Certificate
Someone Else’s Birth Certificate What state did the birth take place?^*

YOUR Current Legal Name^*

(not the person you are filing for)


First^*	Middle	Last^*

Your name and contact information

Whether you are seeking to apply for your birth certificate or are submitting an application for another person (i.e. your child or spouse), please enter YOUR NAME and contact information here.

Applicant’s First Name^*	Middle Name	Last Name^*

Mailing Address
(Address where you would like the birth certificate to be delivered)^*

City^*	State^*	Zip/Postal Code^*

Mailing Address

Where do you want your certificate mailed and delivered?
Same address as above?^*

Yes No

Mailing Street Address^*

City^*	State^*	Zip/Postal Code^*

Phone^* Email Address^*

Relationship - Your relationship to the person on record^*

Relationship to decedent^* State where death occurred^*

Decedent's Name at the Time of Death^*

Decedents First Name^*	Decedents Last Name^*

Year of Death^*

What City was the birth?^*

What is the COUNTY of Birth? (Not COUNTRY)^*

What is YOUR (person filing) Date of Birth?^*

What is YOUR (person filing) Social Security Number?^*

Confirm YOUR Social Security Number?^*

What state was YOUR Social Security Number issued?^*

What is your Drivers License Number?^* What state is your Drivers License from?^*

I Confirm this is MY Date of Birth & MY Social Security Number, not the person I’m filing for AND I confirm that I have reviewed the applicable state law and that I am eligible to apply for and receive the requested individual’s Birth Certificate.

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Birth Certificate Order

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