Birth Certificate Application

Request your official Birth Certificate by Mail from Home

Birth information of the person on record

Please enter the birth information of the individual who needs the birth certificate. If you are applying for someone else (i.e. your child), enter their birth information here.

1.1 First Name at birth*

1.2 Middle Name at birth

1.3 Last name at birth*

Suffix

1.4 Gender*

Male

Female

1.5.a Has the person on record ever changed his/her name through a marriage?

Yes

1.6 Has the person on record ever changed his/her name by court order?

Yes

2.1 Date of birth*

2.2 State of birth*

2.4 City of birth*

Information about the parents of the person on record

Mother's first name*

Mother's middle name

Mother's last name before any marriage (maiden name)*

Mother's last name after marriage if different

Father unknown or not listed on the birth certificate

Yes

Father's first name*

Father's middle name

Father's last name*

Suffix

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.

First name*

Middle name

Last name*

Phone number*

Email address*

Confirm email address*

Address where you would like the birth certificate to be delivered

Street*

Apt, suite, floor, etc.

City*

State*

Zip Code*

Relationship to the person on record

What is your relationship with the person on the certificate?*

Why are you applying for a birth certificate?*

By checking this box, I agree to submit the information provided to this website, and I authorize Vital Records Online to use my information to fill out all necessary documents to prepare my application materials. I understand that VitalRecordsOnline.com is a private document preparation service and that I am hiring them to prepare my birth certificate application materials. By providing my email address and cell phone number, I hereby agree to opt-in email/sms notifications including, but not limited to, application status updates and marketing emails. I understand there is a service fee charged by VitalRecordsOnline.com and for some specific state requirements, I will requires to pay the health department fee directly by check or money order. I understand I will have to provide additional documents or notarized documents to the health department to prove my identity. I understand that I may receive newsletters from VitalRecordsOnline.com. By submitting the form above, I agree to these terms and the terms of this website.