Vital Statistics Forms

Birth and Death Certificate Request Forms    Amendment Forms    Adoption Forms    Paternity and Parentage Forms

Abortion Reporting Forms and Postmortem Examination or Autopsy Consent Form (for physicians only)

 

Request Forms
Birth or Death Record Forms

VS 142.21 – Expedited Application for a Certified Copy

VS 142.21 – Solicitud por Correo Postal de Acta de Nacimiento o Defuncion Mediante Servicio Agilizado

VS 142.3 – Mail Application for a Certified Copy

VS 142.3 – Solicitud por Correo Postal de Acta de Nacimiento o Defuncion

VS 142.6 – Mail Application for a Verification Letter

VS 142.7 Mail Application for a Certified Copy - Military Personnel being Deployed

VS 144 – Heirloom Gift Certificate

VS 301 – Application for Certificate of Birth Resulting in Stillbirth

 

Amendment and Disinterment Forms
Birth or Death Record Amendment Forms
VS 170 – Application for an Amendment to a Birth Record
VS 172 – Application for an Amendment to a Death Record
VS 2318.1A – Application for Amended Birth Certificate based on a Court Ordered Name Change
VS 271 – Application for Disinterment Permit
VS 271.1 – Disinterment Consent Form



Marriage and Divorce Request Forms
Marriage or Divorce Record Forms
VS 142.9 – Application for Marriage/Divorce Verification or Marriage Application
VS 146 – Application for an Heirloom Anniversary Certificate
VS 180 – Application for Marriage License
VS 180.1 – Declaration and Registration of Informal Marriage



Adoption Forms
Adoption Forms PDF
VS 143 – Request for Identity of Court of Adoption Download (79K)
VS 2271 – Central Adoption Registry Application and Instructions Download (39K)
VS 2271 – Central Adoption Registry Application and Instructions (Spanish) Download (128K)
VS-210 Central Adoption Registry Request for Open Records Download (153K)
VS 145 – Adult Adoptee Application for Non-Certified Copy of Original Birth Certificate Download (25K)
VS 160 – Certificate of Adoption (for attorneys and district clerks) Download (53K)
VS 166.531 – Validation Petition Download (23K)
VS 166.532 – Validation Order Download (7K)



Paternity or Parentage Forms
Paternity or Parentage Forms PDF
VS 134 – Paternity Registry Inquiry Request Download (39K)
VS 134.1 – Acknowledgment of Paternity Inquiry Request Download (32K)
VS 165 – Information on Suit Affecting the Family Relationship (Excluding Adoptions)Download (148K)
VS 166 – Application for a New Birth Certificate based on Parentage Download (113K)
VS-168 Inquiry On Court Of Continuing Jurisdiction For A Child Download (83K)



Abortion Reporting Forms to be submitted to Vital Statistics Data Management Group
Form Name PDF
Medical Emergency Abortion form Download (25 KB)
Third Trimester Induced Abortion Certification Form Download (26K)
Induced Abortion Report Form Download (48K)
Abortion Complications Reporting Form Download (415K)

Abortion Forms to be completed and placed in patient file
Form Name PDF
Medical Emergency Abortion form Download (25 KB)
Third Trimester Induced Abortion Certification Form Download (26K)
Induced Abortion Report Form Download (48K)
Abortions Complications Reporting Form  Download (415K)

Postmortem Examination or Autopsy Consent Form (for physicians only)
Form Name PDF
Postmortem Examination or Autopsy Consent Form Download (415K)


 

Last updated August 21, 2017