Get Florida Birth Certificate Form

Get Florida Birth Certificate Form

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.

Structure

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.

Florida Birth Certificate Preview

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

FIRST

MIDDLE

 

 

LAST

SUFFIX

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

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRST

MIDDLE

LAST NAME PRIOR TO FIRST MARRIAGE

SUFFIX

MOTHER’S / PARENT’S

 

 

 

 

(If applicable)

 

NAME

 

 

 

 

 

 

 

 

 

 

 

 

FIRST

MIDDLE

LAST NAME PRIOR TO FIRST MARRIAGE

SUFFIX

FATHER'S / PARENT’S

 

 

 

 

(If applicable)

 

NAME

 

 

 

 

 

 

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

$13.00

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

Optional

 

Notary Services: (Same day service for amendment forms only)

$10.00

Optional

 

(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

DH 1960, 04/2016, Florida Administrative Code Rule 64V-1.0131 (Obsoletes Previous Editions)

Revised 12/1/2021

Document Data

Fact Name Description
Application Availability The Florida Birth Certificate form is available for records from 1917 to the present. Some records date back to 1865.
Governing Law This application is governed by Chapter 382 of the Florida Statutes, which outlines the requirements for vital records.
Eligibility Criteria Only specific individuals can request a birth certificate, including the registrant, parents, legal guardians, or legal representatives.
Identification Requirements Applicants must provide valid photo identification, such as a driver's license or passport, when submitting the application.
Fees The first certified copy costs $13. Additional copies of the same record on the same day are $8 each.
Non-Refundable Fees All fees for vital records are non-refundable, even if the requested record cannot be located.
Computer Certification Computer certifications are accepted by state and federal agencies and come in two formats, depending on the year of the birth record.

How to Use Florida Birth Certificate

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.

  1. Obtain the Application for a Florida Birth Record form from the Florida Department of Health website or the local office.
  2. Read both the front and back of the application thoroughly to understand the requirements and instructions.
  3. In Section A, provide the registrant's information, including:
    • Child’s full name as it appears on the birth record.
    • If applicable, indicate any name changes since birth.
    • Date of birth (month, day, year).
    • Place of birth (hospital, city or town, county).
    • Mother’s and father’s names prior to their first marriage, if applicable.
  4. In Section B, fill in the applicant’s information, including:
    • Full name of the applicant (first, middle, last, and any suffix).
    • Signature of the applicant.
    • Home phone number and alternate phone number.
    • Mailing address, including city, state, and zip code.
    • Relationship to the registrant.
    • If applicable, provide attorney's license or bar number and the name of the person represented.
  5. In Section C, indicate the fee information:
    • Specify the quantity of certified copies needed.
    • Calculate the total cost, including any additional services.
    • Provide credit card information if paying by card or indicate if paying by check or money order.
  6. Ensure that the application is signed and dated by the applicant.
  7. Gather valid photo identification (e.g., driver’s license, passport) to submit with the application.
  8. If mailing the application, make a copy of the valid photo identification to include with the request.
  9. Submit the completed application, identification, and payment to the address listed on the form:
    • Florida Department of Health in Pinellas County
    • Office of Vital Statistics
    • 8751 Ulmerton Rd., Ste. 1700
    • Largo, FL 33771

Key Facts about Florida Birth Certificate

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.

Common mistakes

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.

Documents used along the form

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.

  • Affidavit to Release a Birth Certificate: This document is required if the applicant is not the registrant, parent, guardian, or legal representative. It must be completed by an authorized person to release the birth certificate.
  • Death Certificate: If the registrant is deceased, a death certificate may be needed to obtain a birth certificate for a spouse, child, or other eligible family members. This document provides proof of death and establishes eligibility.
  • Guardianship Papers: If the applicant is a legal guardian, these documents must be submitted to verify the guardianship. This helps ensure that the request for the birth certificate is legitimate and authorized.
  • Court Order: In some cases, a court order may be necessary to obtain a birth certificate, especially if the applicant is not a parent or guardian. This document must clearly state the relationship of the applicant to the registrant.

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.

Similar forms

  • Death Certificate: Similar to a birth certificate, a death certificate provides essential information about an individual's death, including the deceased's name, date of birth, and date of death. Both documents serve as vital records and may require proof of relationship for access.
  • Marriage Certificate: A marriage certificate records the union between two individuals. Like a birth certificate, it includes names, dates, and places, and may be needed for legal purposes such as name changes or spousal benefits.
  • Divorce Decree: This document outlines the legal dissolution of a marriage. It provides details such as the names of both parties and the date of divorce, similar to how a birth certificate records vital information about a person's birth.
  • Adoption Certificate: An adoption certificate serves as legal proof of an adopted child’s new status. It contains information about the child and adoptive parents, akin to the details found on a birth certificate.
  • Social Security Card: A Social Security card is essential for identity verification and benefits. It includes the holder's name and Social Security number, similar to how a birth certificate verifies identity and personal information.
  • Passport: A passport is an official document that verifies identity and nationality. It contains the individual's name, date of birth, and photo, paralleling the identification role of a birth certificate.
  • Voter Registration Card: This card confirms an individual's eligibility to vote and includes personal details such as name and address. Like a birth certificate, it is often required for identification purposes.
  • Health Insurance Card: A health insurance card provides information about the insured individual, including their name and policy number. It serves as proof of identity and coverage, similar to a birth certificate.
  • Driver’s License: A driver’s license verifies an individual’s identity and legal permission to drive. It includes personal information like name and date of birth, similar to the information found on a birth certificate.
  • Military Identification Card: This card identifies active duty and retired military personnel. It includes personal details and serves as proof of identity, much like a birth certificate does for individuals.

Dos and Don'ts

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.

  • Do read the entire application, both front and back, to understand all requirements.
  • Do provide valid photo identification if you are the applicant, parent, guardian, or legal representative.
  • Do ensure that the child's full name is accurately entered as it appears on the birth record.
  • Do indicate any name changes clearly, including the date and location of the change.
  • Do include your relationship to the registrant in the application.
  • Don't submit the application without signing it; your signature is required.
  • Don't forget to include any necessary documents, such as guardianship papers if applicable.
  • Don't use forms of identification that are not listed as acceptable.
  • Don't assume that all applications will be processed immediately; some may require additional verification.
  • Don't overlook the nonrefundable nature of the fees associated with the application.

By adhering to these guidelines, applicants can help ensure that their requests for birth certificates are processed efficiently and accurately.

Misconceptions

Here are six common misconceptions about the Florida Birth Certificate form:

  • Anyone can request a birth certificate. Only specific individuals, such as the registrant, parents, legal guardians, or authorized representatives, can request a birth certificate. Others may need a court order.
  • Photo ID is not necessary for mail requests. A valid photo identification is required for all requests, including mail requests. If you are mailing your application, you must include a copy of your ID.
  • Birth certificates are free to obtain. There are fees associated with obtaining a birth certificate. The first certified copy costs $13.00, and additional copies have their own fees.
  • All birth records are available from 1865. While some records date back to 1865, birth registration was not required until 1917. Therefore, not all records are guaranteed to be available.
  • Changing your name on a birth certificate is simple. If your name has changed since birth, you must provide legal documentation to support the name change, which can complicate the process.
  • Birth records under seal can be ordered like regular records. Birth records sealed due to adoption or court orders cannot be requested through the standard application process. Special procedures must be followed to obtain these records.

Key takeaways

When applying for a Florida Birth Certificate, understanding the process can streamline your experience. Here are some key takeaways:

  • Eligibility Requirements: Only specific individuals can request a birth certificate. This includes the registrant, parents, legal guardians, and legal representatives. If you do not fall into these categories, you will need a court order.
  • Identification is Crucial: Valid photo identification must be provided with your application. Acceptable forms include a driver’s license, state ID, passport, or military ID. If you are mailing your request, include a copy of this identification.
  • Application Completeness: Ensure that all sections of the application are filled out accurately. Missing information can delay processing. Pay attention to the relationship to the registrant and any name changes.
  • Fees and Payment: The first certified copy costs $13. Additional copies are available at a reduced rate. Remember, fees are nonrefundable, so be sure you are eligible before submitting payment.
  • Special Circumstances: If the birth record is under seal due to adoption or court order, a different application process applies. Contact the Bureau of Vital Statistics for guidance.