Division of
Vital Records, Oklahoma State Department of Health
1000 Northeast 10th Street, Post Office Box 53551
Oklahoma City, Oklahoma 73152-3551
APPLICATION FOR SEARCH AND CERTIFIED COPY OF BIRTH CERTIFICATE
Facts Concerning This Birth
If both parents names are not indicated on the original certificate of birth and a "full copy" is desired it will be necessary to have the signature of the mother, or the registrant if of legal age, or if certificate is required for "adoption purposes" the signature of the attorney of record and a statement from him to that effect.
The above signature is by (
) person himself-herself ( ) next-of-kin ( )
authorized agent
Next of Kin / Specify Relationship ________________________________________
Purpose for which this copy is
needed
( ) School ( )Passport (
)Employment ( )Adoption (
)Other (Please state)___________________
Has copy of this persons birth certificate been
received before? ( ) Yes ( ) No ( )Unknown
PLEASE PRINT CORRECT MAILING ADDRESS
BELOW:
Request for a search of the records for a birth certificate
of any person born in Oklahoma should be submitted on this form along with the
required fee of $10.00 If the birth record is on file, a certified copy will
be mailed. If no record of the birth is found, then blanks and instructions
for filing a "delayed" birth certificate will be sent. This fee will
be credited on the $10.00 fee required for the first certified copy from the
delayed record after it has been placed on file.
The information requested above should be filled in carefully and accurately.
It is the minimum needed in the Vital Records office to make a thorough search
for any birth record.
Send ten dollars ($10.00) in cash, money order or check for each copy desired.
Cash is sent at sender's risk. Make checks or money orders payable to the State
Department of Health.
A copy required to be submitted to the Veterans Administration
or U.S. Commissioner of Pensions, in connection with a claim for military-service-connected
benefits may be obtained without fee provided a signed statement is attached
which sets forth these facts and requests that the copy be issued without fee.
Members of the armed forces and veterans must pay regular fees for copies to
be used for all other purposes.
A valid, legal photo I.D. is required from the
applicant or the individual
representing the applicant for the issuance of a birth, death or stillbirth
certificate.
Do not send original ID with your application. Please send a photocopy.
VS 151 R9-03