Two types of certified birth certificates are available. This certified certificate shows child's name, date and county of birth, state file number, filing and issue dates, and is sufficient for proof of birth but will not satisfy claims requiring proof of dependency e.g. IRS, Social Security, Welfare. This type certified certificate will satisfy claims requiring proof of dependency and situations where for family, historical or legal reasons additional information is required. A five year search of records on file will be made.
Instructions Complete all the information sections of the form.
The application must be signed. We accept no responsibility for cash sent through the mail. Request for adjustments or refunds will be honored only if received within six months of application. Send completed application, appropriate fee and self-addressed stamped legal size envelope to the address at the top of this form. Please print one of the following application forms.