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Fill in Your Florida Birth Certificate Form

The Florida Birth Certificate form is an application used to request a certified copy of a birth record in Florida. This form is essential for individuals who need to obtain their own birth certificate or that of a child, parent, or legal representative. To begin the process of obtaining a birth certificate, please fill out the form by clicking the button below.

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The Florida Birth Certificate form is an essential document for obtaining a certified copy of a birth record, which is crucial for various legal and personal purposes. This form, managed by the Florida Department of Health in Pinellas County, has been in use since 1917 and is available for individuals born in Florida from that year onward. To request a birth certificate, applicants must provide valid photo identification, such as a driver's license or passport, and complete the application accurately. The form requires detailed information about the child, including their full name, date of birth, and place of birth, as well as parental details. Additionally, the applicant's information must be filled out, including their relationship to the registrant. Fees for obtaining a birth certificate vary, with options for additional copies and expedited services. It's important to note that certain eligibility criteria apply, and specific procedures must be followed for those requesting records under seal. Understanding these requirements can simplify the process and ensure that individuals receive the necessary documentation without delay.

Form Sample

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

File Details

Fact Name Details
Form Title Application for a Florida Birth Record
Availability Birth records are available from 1917 to the present. Some records date back to 1865.
Governing Laws Chapter 382 and Chapter 775 of the Florida Statutes govern the issuance and regulation of birth certificates.
Identification Requirement Applicants must provide valid photo identification, such as a driver's license or passport.
Eligibility Criteria Only the registrant, parents, guardians, or legal representatives can request a birth certificate.
Non-refundable Fees The search fee for a birth record is non-refundable, even if the record is not found.
Application Process Complete the application and submit it along with the required identification and fees.
Birth Records Under Seal Records sealed due to adoption or court order must be requested through the Bureau of Vital Statistics.
Computer Certifications Computer certifications are accepted for travel and include essential birth details.
Contact Information For assistance, contact the Florida Department of Health in Pinellas County at (727) 507-4330.

Detailed Instructions for Writing Florida Birth Certificate

Completing the Florida Birth Certificate form is a straightforward process, but it requires careful attention to detail. Make sure to have your valid photo identification ready, as it will be necessary to submit with your application. Once you've filled out the form, you will need to follow the instructions for submission, which may involve mailing or visiting the local health department.

  1. Obtain the Florida Birth Certificate form from the Florida Department of Health website or visit the local health department.
  2. Read both the front and back of the application carefully to understand the requirements.
  3. In Section A, fill in the child's full name as it appears on the birth record, including any suffixes. If the name has changed since birth, indicate the new name.
  4. Provide the child's date of birth, sex, and place of birth, including the hospital, city, and county.
  5. List the mother's and father's names as they appear on the birth record, including any suffixes and names prior to first marriage.
  6. In Section B, enter the applicant's full name, signature, home phone number, mailing address, and relationship to the registrant.
  7. If applicable, include the attorney’s bar number and the name of the person represented along with their relationship to the registrant.
  8. In Section C, indicate the quantity and total cost for the certified copies and any additional services you wish to request.
  9. Provide your payment information, including credit card details if applicable, and ensure the credit card holder's name and signature are included.
  10. Attach a copy of your valid photo identification to the application if submitting by mail.
  11. Submit the completed form either in person at the local health department or by mail to the address provided on the form.

Essential Questions on Florida Birth Certificate

What is the process for obtaining a Florida birth certificate?

To obtain a Florida birth certificate, you must complete the application form provided by the Florida Department of Health. If you are the registrant, a parent, guardian, or legal representative, you will need to provide valid photo identification. If you are making a request by mail, include a copy of your ID. If you are not one of the eligible individuals, an authorized person must complete an Affidavit to Release a Birth Certificate and submit it along with your application.

What forms of identification are accepted?

Acceptable forms of identification include:

  • Driver’s License
  • State Identification Card
  • Passport
  • Military Identification Card

Ensure that the identification is valid and current to avoid delays in processing your request.

Who is eligible to request a birth certificate?

Eligibility to request a birth certificate is limited to the following individuals:

  1. The registrant, if they are 18 years or older.
  2. Parent(s) listed on the birth record.
  3. Legal guardian, with guardianship papers.
  4. Legal representative of one of the above persons.
  5. Others with a court order, providing a certified copy of the order.

In cases where the registrant is deceased, a spouse, child, grandchild, sibling, or legal representative may request the certificate with the death certificate included.

What are the fees associated with obtaining a birth certificate?

The fees for obtaining a Florida birth certificate are as follows:

  • First Certified Copy: $13.00
  • Additional Certified Copy (same person): $8.00
  • Protective Plastic Sleeve: $2.00
  • Fax or Mail Rush Orders: $5.00
  • Optional Fed/Ex Delivery: $17.00
  • Optional Notary Services: $10.00

Note that these fees are non-refundable, and you will be charged a search fee before your application is processed.

How long does it take to receive a birth certificate?

Standard processing times can vary. Generally, if you request a birth certificate by mail, it may take longer than if you apply in person. For rush orders, the birth certificate will typically be mailed out within 2-3 business days. However, it is advisable to check for any specific updates or changes in processing times.

Can I obtain a birth certificate for someone else?

Yes, you can obtain a birth certificate for someone else, but you must meet the eligibility criteria outlined above. If you are not the registrant, parent, or legal guardian, you will need to provide a notarized Affidavit to Release a Birth Certificate along with your application. Ensure that all necessary documentation is included to avoid delays.

What should I do if the birth record is under seal?

For birth records that are under seal due to adoption, paternity determination, or court order, you cannot request them through the standard application process. Instead, you must write to the Bureau of Vital Statistics at the address provided in the application instructions. Include all relevant information and documentation to facilitate your request.

Is a computer certification acceptable for travel purposes?

Yes, a computer certification is accepted by all state and federal agencies and can be used for various purposes, including travel. There are two formats of computer certifications based on the year of birth. Ensure you specify the correct format when applying for the certification.

Common mistakes

Filling out the Florida Birth Certificate form can seem straightforward, but many people make common mistakes that can lead to delays or complications. One frequent error occurs when applicants fail to read the instructions on both the front and back of the application. Ignoring these guidelines can result in missing critical information or not understanding the requirements for identification. This oversight can cause unnecessary frustration.

Another common mistake is not providing valid photo identification. If you are applying by mail, a copy of your ID is necessary. Many applicants forget this crucial step, which can lead to their application being rejected. Acceptable forms of ID include a driver’s license, state ID card, passport, or military ID. Without these, the process halts.

Additionally, applicants often overlook the section that requires them to clarify their relationship to the registrant. Some people simply write “self” without explaining name changes or other relevant details. This lack of clarity can create confusion and delay the processing of the application.

Inaccuracies in the registrant's information are another significant issue. When filling out the child's full name, date of birth, or place of birth, applicants sometimes provide incorrect details. Even a small mistake can lead to complications, especially if a birth certificate is needed for legal purposes. Double-checking this information is essential.

People sometimes forget to sign the application. A signature is a vital part of the process, and without it, the application cannot be processed. This simple oversight can lead to delays, and applicants may find themselves waiting longer than necessary.

Moreover, applicants often miscalculate fees. They may not include the correct amount for the certified copy or additional services like rush orders or protective sleeves. It’s important to review the fee structure carefully and ensure that the total is accurate to avoid processing delays.

Some applicants fail to provide a complete mailing address. Omitting apartment numbers or ZIP codes can lead to returned applications or lost documents. Ensuring that all contact information is accurate helps facilitate smoother communication with the health department.

Another mistake involves not including necessary documentation when applying on behalf of someone else. If you are a legal guardian or representative, you must submit additional paperwork, such as guardianship papers or a notarized affidavit. Missing these documents can result in the application being put on hold.

Lastly, many applicants neglect to consider the time frame for processing. They may expect immediate results without factoring in that rush orders come with additional fees and still require a few days to process. Understanding the timeline can help set realistic expectations and reduce anxiety during the waiting period.

Documents used along the form

When applying for a Florida birth certificate, several additional forms and documents may be necessary to ensure a smooth process. Each of these documents serves a specific purpose, helping to verify identity or establish eligibility. Understanding these requirements can streamline your application and prevent potential delays.

  • Affidavit to Release a Birth Certificate: This document is required if the applicant is not the registrant, a parent, guardian, or legal representative. It must be completed by an authorized person and submitted alongside the birth certificate application. This affidavit confirms the authority of the individual requesting the certificate.
  • Valid Photo Identification: Applicants must provide a valid form of photo ID, such as a driver’s license, state identification card, passport, or military identification card. This identification is crucial for verifying the identity of the applicant and ensuring that the request is legitimate.
  • Guardianship Papers: If the applicant is a legal guardian of the registrant, they must include official documentation proving their guardianship. This ensures that the individual requesting the birth certificate has the legal right to do so on behalf of the registrant.
  • Death Certificate: In cases where the registrant is deceased, a death certificate is necessary to request a birth certificate. This document serves as proof of the registrant's passing and allows eligible family members or legal representatives to obtain a copy of the birth record.

By familiarizing yourself with these additional documents, you can better prepare for the application process. Each piece of paperwork plays a vital role in ensuring that the birth certificate request is handled appropriately and efficiently.

Similar forms

The Florida Birth Certificate form shares similarities with the Social Security card application. Both documents serve as essential identity verification tools, allowing individuals to establish their identity for various purposes, such as employment and government services. When applying for a Social Security card, applicants must provide proof of identity, much like the requirement for valid photo identification when requesting a birth certificate. The application processes for both documents necessitate accurate personal information, including full names and dates of birth, ensuring that the records are correctly associated with the individual.

Another document akin to the Florida Birth Certificate form is the passport application. A passport serves as an official identification document required for international travel, while a birth certificate is often a foundational document needed to obtain a passport. Both applications require detailed personal information, including the applicant's full name, date of birth, and place of birth. Additionally, both processes necessitate proof of identity, and applicants must submit supporting documents to verify their information, ensuring the integrity of the identification issued.

The marriage certificate application also bears similarities to the Florida Birth Certificate form. A marriage certificate serves as legal proof of a marriage, just as a birth certificate serves as proof of birth. Both documents require the submission of personal information, such as full names and dates of birth, of the individuals involved. Furthermore, both applications typically require identification to confirm the identity of the applicants. In some cases, individuals may need to provide additional documentation, such as divorce decrees or parental consent, depending on their circumstances.

Lastly, the driver's license application parallels the Florida Birth Certificate form in its role as a key identification document. A driver's license is often used for identification purposes in various situations, including travel and age verification. Similar to the birth certificate application, the driver's license application requires personal details, including the applicant's full name, date of birth, and address. Both processes mandate proof of identity and residency, ensuring that the issued identification accurately reflects the individual’s information. Additionally, both applications may involve a fee, and applicants must comply with specific eligibility requirements to obtain the respective documents.

Dos and Don'ts

When filling out the Florida Birth Certificate form, there are important guidelines to follow to ensure a smooth application process. Here are four things you should and shouldn't do:

  • Do provide valid photo identification. If you are the applicant, parent, guardian, or legal representative, make sure to include a copy of your valid photo ID with your application.
  • Do read the entire application. Take the time to read both the front and back of the application form to understand all requirements.
  • Don't provide false information. Providing incorrect details can lead to serious consequences, including legal penalties.
  • Don't forget to sign the application. Ensure that you sign and print your name on the application to avoid delays in processing.

Misconceptions

Here are nine misconceptions about the Florida Birth Certificate form, along with clarifications for each:

  1. Only parents can request a birth certificate. Many people believe that only parents can obtain a birth certificate. In fact, legal guardians and legal representatives can also request one, provided they have the necessary documentation.
  2. Identification is not required for mail requests. Some think that they can request a birth certificate by mail without identification. However, a copy of valid photo identification must be included with any mail request.
  3. All birth records are available without restrictions. There is a misconception that anyone can access any birth record. Certain records, especially those under seal due to adoption or court orders, cannot be ordered in the usual manner.
  4. Birth certificates are free to obtain. Many assume that birth certificates are free. However, there are fees associated with obtaining a certified copy, which vary based on the type of request.
  5. Only original applications are accepted. Some people believe that only original applications can be processed. In reality, completed applications can be submitted via mail or fax, provided all required documentation is included.
  6. Computer certifications are not valid. There is a misconception that computer certifications are not acceptable. In fact, they are recognized by state and federal agencies and can be used for various purposes, including travel.
  7. There is no time limit on requesting a birth certificate. Some think they can request a birth certificate at any time without restrictions. However, if the registrant is deceased, certain documentation, such as a death certificate, is required.
  8. Anyone can change the name on a birth certificate. Many believe that name changes can be easily processed. However, legal name changes must be documented and submitted with the application.
  9. Only the registrant can provide information for the application. Some assume that only the individual named on the birth certificate can provide information. In fact, parents or legal representatives can fill out the application if they meet eligibility requirements.

Key takeaways

  • Ensure you have valid photo identification when completing the Florida Birth Certificate application. Acceptable forms include a Driver’s License, State ID, Passport, or Military ID.

  • If you are not the registrant, parent, or legal guardian, you must submit an Affidavit to Release a Birth Certificate, completed by an authorized person.

  • Be aware that fees for vital records are nonrefundable. The initial search fee is $13, with additional copies available for $8 each.

  • Understand the eligibility criteria. Birth certificates can only be issued to the registrant, parents, legal guardians, or legal representatives, among others.

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