The Florida Birth Certificate form is an official document used to request a certified copy of a birth record in the state of Florida. This application is crucial for individuals needing proof of birth for various legal and personal purposes, such as applying for a passport or enrolling in school. To get started, fill out the form by clicking the button below.
The Florida Birth Certificate form is a vital document that serves as an official record of a person's birth, and it is essential for various legal and personal purposes. This form is available for births registered from 1917 to the present, ensuring that individuals can access their birth records when needed. To obtain a birth certificate, applicants must complete the application and provide valid photo identification. This requirement applies to the registrant, parents, guardians, or legal representatives. If the applicant does not fall into these categories, an additional affidavit must be submitted by an authorized person. The application includes sections for registrant information, such as the child's full name, date of birth, and parental details, as well as the applicant's information. Notably, the form outlines the fees associated with obtaining certified copies, which vary based on the number of copies requested and the delivery method chosen. It is important to understand that providing false information on this form can lead to serious legal consequences. Additionally, certain eligibility criteria dictate who can request a birth certificate, with specific provisions for deceased registrants. The form also addresses situations involving sealed records, such as those related to adoption or court orders, which require a different process for access. Overall, the Florida Birth Certificate form is a crucial document that facilitates identity verification and serves as a cornerstone for many legal proceedings.
APPLICATION FOR A FLORIDA BIRTH RECORD
(1917 to present years available)
Florida Department of Health in Pinellas County/Office of Vital Statistics
8751 Ulmerton Rd., Ste. 1700, Largo, FL 33771 (*M-F 8-4:30 pm) (#727-507-4330 x 6316 / Fax #727-507-4335)
Read the FRONT AND BACK of this application: Requirement for ordering: If applicant is self, parent, guardian, or legal representative, then the applicant must complete this application and provide valid photo identification, if a mail request, a copy of the valid photo identification must be provided. If applicant is not one of the above, the Affidavit to Release a Birth Certificate must be completed by an authorized person and submitted in addition to this application form. Acceptable forms of identification are the following: Driver’s License, State Identification Card, Passport, and/or Military Identification Card.
SECTION A: REGISTRANT INFORMATION
CHILD’S FULL NAME AS
FIRST
MIDDLE
LAST
SUFFIX
SHOWN ON BIRTH
RECORD
IF NAME WAS CHANGED
SINCE BIRTH, INDICATE
NEW NAME
MONTH
DAY
YEAR (4 DIGIT)
STATE FILE NUMBER (If known)
SEX
DATE OF BIRTH
HOSPITAL
CITY OR TOWN
COUNTY
PLACE OF BIRTH
LAST NAME PRIOR TO FIRST MARRIAGE
MOTHER’S / PARENT’S
(If applicable)
NAME
FATHER'S / PARENT’S
IMPORTANT INFORMATION
Any person who willfully and knowingly provides any false information on a certificate, record or report required by Chapter 382, Florida
Statutes, or on any application or affidavit, or who obtains confidential information from any Vital Record under false or fraudulent
purposes, commits a felony of the third degree, punishable as provided in Chapter 775, Florida Statutes.
SECTION B: APPLICANT (adult requesting certificate) INFORMATION
Applicant’s Name
FIRST, MIDDLE, LAST (INCLUDING ANY SUFFIX)
SIGNATURE OF APPLICANT
TYPE OR PRINT
HOME PHONE NUMBER
MAILING ADDRESS (INCLUDE APT. NO., IF APPLICABLE)
RELATIONSHIP TO REGISTRANT
(
)
ALTERNATE PHONE NUMBER
CITY
STATE
ZIP CODE
IF ATTORNEY, PROVIDE
LICENSE/ BAR NUMBER
NAME OF PERSON REPRESENTED
and THEIR RELATIONSHIP TO REGISTRANT
BAR/PROFESSIONAL LICENSE NO.
SECTION C: COUNTY HEALTH DEPARTMENT FEE INFORMATION
(Our website http://pinellas.floridahealth.gov/certificates/index.html to order online-addl fees apply)
Cost
Quantity
Total
1st Certified Copy: (*Non-refundable fee for Birth Record search)
$13.00
1
Additional Certified Copy: (Same day of purchase on the same person)
$8.00
Protective Plastic Sleeve:
$2.00
Fax or Mail Rush Orders: (Mail out within 2-3 business days by regular mail)
$5.00
Optional
Fed/Ex Delivery:(Mail out within 2-3 business days-no PO/APO Boxes-Continental US)
$17.00
Notary Services: (Same day service for amendment forms only)
$10.00
(Check or Money Order Payable to Vital Statistics)(Accepting Visa, Mastercard, Discover, or Amex)
TOTAL:
Credit Card Holder's Name
CC#
Exp
Sec
Date
Code
CCBilling Address/Zip CC Holder's Signature
DH 1960, 04/2016, Florida Administrative Code Rule 64V-1.0131 (Obsoletes Previous Editions)
Revised 12/1/2021
INFORMATION AND INSTRUCTIONS FOR BIRTH RECORD APPLICATION
COMPUTER CERTIFICATION: computer certifications are accepted by all state and federal agencies and used for any type of travel.
A computer certification has two different formats:
1.A certification of a registered birth (2004 to present), supplies the following facts of birth: Child's Name, Date of Birth, Sex, Time, Weight, Place of Birth (City, County and Location) and Parents' Information.
2.A certification of a registered birth (1930 to 2003), supplies the following facts of birth: Child's Name, Date of Birth, Sex, County of Birth and Parents' Name.
AVAILABILITY: Birth registration was not required by state law until 1917, but there are some records on file dating back to 1865.
ELIGIBILITY: Birth certificates can be issued only to:
1.Registrant (the child named on the record) if of legal age (18)
2.Parent(s) listed on the Birth Record
3.Legal guardian (must provide guardianship papers)
4.Legal representative of one of the above persons
5.Other person(s) by court order (must provide recorded or certified copy of court order)
In the case of a deceased registrant, upon receipt of the death certificate of the decedent, a certification of the birth certificate can be issued to the spouse, child, grandchild, sibling, if of legal age, or to the legal representative of any of these persons as well as to the parent.
Any person of legal age may be issued a certified copy of a birth record (except for those birth records under seal) for a birth event that occurred over 100 years ago.
BIRTH RECORDS UNDER SEAL: Birth records under seal by reason of adoption, paternity determination or court order cannot be ordered in the usual manner. For a record under seal, write to:
BUREAU OF VITAL STATISTICS
ATTN: Records Amendment Section
P.O. BOX 210
Jacksonville, FL 32231-0042
REQUIREMENT FOR ORDERING: If applicant is self, parent, legal guardian or legal representative, the applicant must provide a completed application along with valid photo identification, if a mail request, a copy of the valid photo identification must be provided. If legal guardian, a copy of the appointment orders must be included with the request. If legal representative, the attorney bar number, and a notation of whom the attorney represents and that person's relationship to the registrant must be included with your request. If you are an agent of local, state or federal agency requesting a record, indicate in the space provided for “relationship” the name of the agency. Acceptable forms of identification are the following: Driver’s License, State Identification Card, Passport and/or Military Identification Card.
If not one of the above, you must complete this application and have a notarized Affidavit to Release A Birth Certificate (DH Form 1958, 08/2010) submitted with your application for the birth record along with a copy of the registrant's valid photo identification as well as the applicant's valid photo identification.
RELATIONSHIP TO REGISTRANT: A person ordering his or her own certificate should enter "SELF" in this space. Also, explain if name has been changed; married name, name changed legally (when and where), etc. Others must identify themselves clearly as eligible (see ELIGIBILITY above).
*NONREFUNDABLE: Vital record fees are nonrefundable.An eligibly verification will be completed before charging the nonrefundable search fee for applicants that will need to send additional forms and payment to the State Office in Jacksonville before a certificate can be released to them (Adoptions, Paternity, and Legal Name Changes).
APPLICANT’S SIGNATURE: Is required, as well as his/her printed name, residence address and telephone number.
COUNTY HEALTH DEPARTMENT NAME AND ADDRESS
Completing the Florida Birth Certificate form requires careful attention to detail. After filling out the form, applicants will need to submit it along with any required identification and payment to the appropriate office for processing.
What is the process for applying for a Florida Birth Certificate?
To apply for a Florida Birth Certificate, you need to complete the application form. If you are the registrant, a parent, guardian, or legal representative, you must provide valid photo identification. This can include a Driver’s License, State ID Card, Passport, or Military ID. If you are making a request by mail, include a copy of your ID. If you are not one of the eligible applicants, an Affidavit to Release a Birth Certificate must be completed by an authorized person and submitted with your application.
Who is eligible to request a Florida Birth Certificate?
Eligibility to request a birth certificate is limited to specific individuals. This includes the registrant if they are 18 or older, the parents listed on the birth record, legal guardians, and legal representatives. In cases where the registrant is deceased, a spouse, child, grandchild, sibling, or legal representative may request the certificate if they provide a death certificate. Additionally, anyone can obtain a certified copy of a birth record that occurred over 100 years ago, unless it is under seal.
What forms of identification are acceptable when applying?
When applying for a Florida Birth Certificate, you must provide valid photo identification. Acceptable forms include a Driver’s License, State Identification Card, Passport, or Military Identification Card. If you are a legal guardian or representative, additional documentation may be required, such as guardianship papers or attorney bar numbers.
What are the fees associated with obtaining a Florida Birth Certificate?
The first certified copy of a birth record costs $13.00, while additional copies purchased on the same day for the same person are $8.00 each. If you need a protective plastic sleeve, it costs $2.00. Rush orders via fax or mail will incur an additional fee of $5.00, and FedEx delivery is available for $17.00. Note that all fees are non-refundable.
Can I request a Florida Birth Certificate online?
Yes, you can order a Florida Birth Certificate online through the Florida Department of Health's website. However, additional fees may apply for online requests. Ensure that you have all necessary information and identification ready when placing your order online.
What should I do if I need a birth record that is under seal?
If you need a birth record that is under seal due to adoption, paternity determination, or a court order, you cannot request it through the usual application process. Instead, you must write to the Bureau of Vital Statistics at the designated address, providing any necessary information and documentation required for your request.
Completing the Florida Birth Certificate application can be a straightforward process, but there are common mistakes that individuals often make. These errors can lead to delays or complications in obtaining the necessary documents. Awareness of these pitfalls can help ensure a smoother experience.
One frequent mistake is failing to provide valid photo identification. The application requires that applicants present a valid form of ID, such as a driver’s license or passport. If the application is submitted by mail, a copy of this identification must accompany the request. Neglecting this step can result in the application being rejected.
Another common error is incomplete registrant information. Applicants must fill out all sections pertaining to the child’s full name, date of birth, and place of birth. Omitting details or providing incorrect information can lead to significant delays. It is essential to double-check this information against official documents to ensure accuracy.
Additionally, many applicants overlook the relationship to the registrant section. If the applicant is ordering their own certificate, they should indicate "SELF." Others must clearly identify their relationship to the child. Failing to do so can create confusion and potentially lead to the application being processed incorrectly.
Another mistake often made is not including the appropriate fees. The application outlines specific costs for obtaining certified copies. Applicants should ensure that they include the correct payment, whether by check, money order, or credit card information. Missing or incorrect payment can delay the processing of the application.
Some individuals also forget to sign the application. The applicant’s signature is a crucial part of the process. Without it, the application cannot be processed. It is advisable to review the application thoroughly before submission to ensure that all required fields are completed.
Lastly, applicants may not be aware of the nonrefundable nature of the fees. The application states that fees are nonrefundable, even if the request is denied due to errors. Understanding this policy can help applicants be more diligent in ensuring their application is complete and accurate before submission.
When applying for a Florida Birth Certificate, there are several other documents that may be needed or helpful in the process. Here’s a brief overview of four common forms and documents often used alongside the birth certificate application.
Having these documents ready can help streamline the process of obtaining a Florida Birth Certificate. It's always best to check the specific requirements based on your situation to avoid any delays.
When filling out the Florida Birth Certificate form, it is essential to follow specific guidelines to ensure a smooth application process. Below are ten important dos and don'ts to consider.
By adhering to these guidelines, applicants can help ensure that their requests for birth certificates are processed efficiently and accurately.
Here are six common misconceptions about the Florida Birth Certificate form:
When applying for a Florida Birth Certificate, understanding the process can streamline your experience. Here are some key takeaways: