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    علي جوده
    This document provides instructions for applying for a certified copy of a Delaware birth certificate. It lists the office locations and contact information for the Office of Vital Statistics. The application requests information such as the name on the birth certificate, date of birth, place of birth, parents' names, and the applicant's relationship to the person on the certificate. It notes that a $25 fee is required per copy and valid photo ID must be provided. False statements or unlawful attempts to obtain a certificate are a felony under Delaware law.

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    علي جوده
    84 views1 page
    This document provides instructions for applying for a certified copy of a Delaware birth certificate. It lists the office locations and contact information for the Office of Vital Statistics. The application requests information such as the name on the birth certificate, date of birth, place of birth, parents' names, and the applicant's relationship to the person on the certificate. It notes that a $25 fee is required per copy and valid photo ID must be provided. False statements or unlawful attempts to obtain a certificate are a felony under Delaware law.

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    This document provides instructions for applying for a certified copy of a Delaware birth certificate. It lists the office locations and contact information for the Office of Vital Statistics. The application requests information such as the name on the birth certificate, date of birth, place of birth, parents' names, and the applicant's relationship to the person on the certificate. It notes that a $25 fee is required per copy and valid photo ID must be provided. False statements or unlawful attempts to obtain a certificate are a felony under Delaware law.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    84 views1 page

    11

    Uploaded by

    علي جوده
    This document provides instructions for applying for a certified copy of a Delaware birth certificate. It lists the office locations and contact information for the Office of Vital Statistics. The application requests information such as the name on the birth certificate, date of birth, place of birth, parents' names, and the applicant's relationship to the person on the certificate. It notes that a $25 fee is required per copy and valid photo ID must be provided. False statements or unlawful attempts to obtain a certificate are a felony under Delaware law.

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    OFFICE OF VITAL STATISTICS

    JESSE S. COOPER BLDG. CHOPIN BUILDING THURMAN ADAMS STATE SERV CTR.
    417 FEDERAL STREET 258 CHAPMAN RD. 546 S. BEDFORD ST.
    DOVER , DE 19901 NEWARK, DE 19702 GEORGETOWN, DE 19947
     (302) 744-4549  (302) 283-7130  (302) 856-5495

    CREDIT CARD ORDERS VIA THE INTERNET

    APPLICATION FOR A CERTIFIED COPY OF A DELAWARE BIRTH CERTIFICATE


    PLEASE COMPLETE ALL ITEMS REQUESTED BELOW AS ACCURATELY AS POSSIBLE.

    Name on Birth Certificate


    First Name Middle Name Last Name on Birth Certificate

    Sex Male Female Date of Birth (mm/dd/yyyy)

    Place of Birth
    City State Hospital if Known

    Name of Mother or
    Name of Parent A First Name Middle Name Last Name on Birth Certificate

    Name of Father or
    Name of Parent B First Name Middle Name Last Name on Birth Certificate

    RELATIONSHIP TO THE PERSON WHOSE BIRTH CERTIFICATE YOU ARE REQUESTING (PLEASE CHECK ONE BOX)

    Myself I am the legal guardian (court order required)


    My current husband or wife* I am the authorized agent, attorney or legal representative
    My child of the person listed in 1-5 (proof required)
    My parent*
    *Proof of relationship (eg. marriage or birth certificate)
    Number of copies requested: ____________

    REQUIRED UPON FILING OF APPLICATION


    1. Cost: $25.00 per copy (If record is not located, fee will be retained for search). Make checks or money orders payable
    to the Office of Vital Statistics.
    2. Copy of your official valid photo identification (Drivers license, State ID or Work ID)
    3. Parent’s identification needed for children

    PERSON APPLYING FOR CERTIFICATE


    I hereby certify that all the above information is true to the best of my knowledge. It is a felony violation of Delaware Law
    (16 Del. C.§3111) to make a false statement on this application or to unlawfully obtain a certified copy of a birth certificate.
    Print name of person applying for certificate
    Signature of person applying for certificate Date
    Street Address
    City/Town State
    Zipcode Daytime Phone

    FOR OFFICE OF VITAL STATISTICS USE ONLY


    Identification:
    Rev. Dec 2017

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