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Outline

The Florida Birth Certificate form serves as a critical document for individuals seeking to obtain a certified copy of a birth record in the state. This application is managed by the Florida Department of Health in Pinellas County and is available for records dating from 1917 to the present. To successfully complete the application, individuals must provide specific information regarding the registrant, including the child's full name, date of birth, and parents' names. Additionally, the applicant must indicate their relationship to the registrant and provide valid photo identification, especially when submitting the form via mail. There are strict eligibility requirements, ensuring that only authorized individuals—such as the registrant, parents, or legal guardians—can request a birth certificate. Notably, the form outlines the fees associated with obtaining the certificate, including costs for additional copies and expedited services. Furthermore, applicants must be aware of the serious legal implications of providing false information, which is classified as a felony under Florida law. Understanding the nuances of this form is essential for anyone navigating the process of obtaining vital records in Florida.

Sample - Florida Birth Certificate Form

SUFFIX
SUFFIX
SEX
SUFFIX
SUFFIX
and THEIR RELATIONSHIP TO REGISTRANT
Cost Quantity Total
$13.00 1 $13.00
$8.00
$2.00
$5.00 Optional
Fed/Ex Delivery:(Mail out within 2-3 business days-no PO/APO Boxes-Continental US)
$17.00
Optional
$10.00 Optional
TOTAL:
(Check or Money Order Payable to Vital Statistics)(Accepting Visa, Mastercard, Discover, or Amex)
Credit Card Holder's Name CC Billing Address/Zip
CC#
Exp
Date
Sec
Code
CC Holder's Signature
Notary Services: (Same day service for amendment forms only)
1st Certified Copy: (*Non-refundable fee for Birth Record search)
Additional Certified Copy: (Same day of purchase on the same person)
Protective Plastic Sleeve:
Fax or Mail Rush Orders: (Mail out within 2-3 business days by regular mail)
SECTION C: COUNTY HEALTH DEPARTMENT FEE INFORMATION
(Our website http://pinellas.floridahealth.gov/certificates/index.html to order online-addl fees apply)
LICENSE/ BAR NUMBER
NAME OF PERSON REPRESENTED
IF ATTORNEY, PROVIDE
BAR/PROFESSIONAL LICENSE NO.
CHILD’S FULL NAME AS
SHOWN ON BIRTH
RECORD
APPLICATION FOR A FLORIDA BIRTH RECORD
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
FIRST
LAST
(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)
RELATIONSHIP TO REGISTRANT
MAILING ADDRESS (INCLUDE APT. NO., IF APPLICABLE)
ZIP CODE
ALTERNATE PHONE NUMBER
CITY
HOME PHONE NUMBER
STATE
( )
( )
TYPE OR PRINT
FATHER'S / PARENT’S
NAME
FIRST
CITY OR TOWN
PLACE OF BIRTH
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.
FIRST, MIDDLE, LAST (INCLUDING ANY SUFFIX)
SECTION B: APPLICANT (adult requesting certificate) INFORMATION
SIGNATURE OF APPLICANT
Applicant’s Name
LAST NAME PRIOR TO FIRST MARRIAGE
(If applicable)
(If applicable)
IMPORTANT INFORMATION
COUNTY
MOTHER’S / PARENT’S
NAME
DATE OF BIRTH
MONTH
STATE FILE NUMBER (If known)
FIRST
IF NAME WAS CHANGED
SINCE BIRTH, INDICATE
NEW NAME
HOSPITAL
LAST NAME PRIOR TO FIRST MARRIAGE
FIRST
LAST
DAY
DH 1960, 04/2016, Florida Administrative Code Rule 64V-1.0131 (Obsoletes Previous Editions)
Revised 12/1/2021
A computer certification has two different formats:
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)
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).
APPLICANT’S SIGNATURE: Is required, as well as his/her printed name, residence address and telephone number.
COUNTY HEALTH DEPARTMENT NAME AND ADDRESS
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.
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.
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.
*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).
DH 1960, 04/2016, Florida Administrative Code Rule 64V-1.0131 (Obsoletes Previous Editions)
Revised 12/1/2021

Form Information

Fact Name Description
Application Availability The Florida Birth Certificate application is available for records from 1917 to the present.
Governing Law This application is governed by Chapter 382 of the Florida Statutes.
Identification Requirement Applicants must provide valid photo identification when submitting the application.
Eligible Applicants Only the registrant, parents, guardians, or legal representatives can request a birth certificate.
False Information Penalty Providing false information on the application is a third-degree felony.
Fees The first certified copy costs $13.00, with additional copies available for $8.00 each.
Birth Records Under Seal Records under seal due to adoption or court order cannot be ordered in the usual manner.
Computer Certification Computer certifications are accepted by state and federal agencies for travel purposes.
Application Address The application must be sent to the Florida Department of Health in Pinellas County.
Nonrefundable Fees All fees for vital records are nonrefundable, regardless of whether the record is found.

Detailed Guide for Filling Out Florida Birth Certificate

After completing the Florida Birth Certificate form, submit it to the appropriate health department. Ensure you have included all necessary identification and payment information. The processing time may vary, so check the department's website for updates.

  1. Obtain the Florida Birth Certificate form from the Florida Department of Health or their website.
  2. Read the front and back of the application carefully.
  3. Fill out Section A with the registrant's information, including the child's full name, date of birth, and parents' names.
  4. Complete Section B with the applicant's information, including name, signature, and relationship to the registrant.
  5. In Section C, indicate the fee information, including the number of copies requested and any additional services.
  6. Provide a valid photo identification, such as a driver's license or passport, if you are the applicant.
  7. Sign and date the application form.
  8. Submit the completed form along with payment to the specified address.

Obtain Answers on Florida Birth Certificate

  1. What is required to apply for a Florida Birth Certificate?

    To apply for a Florida Birth Certificate, the applicant must complete the application form and provide valid photo identification. This applies if the applicant is the registrant (the person named on the birth record), a parent, guardian, or legal representative. If the application is submitted by mail, a copy of the valid photo ID must also be included. Acceptable forms of identification include a Driver’s License, State Identification Card, Passport, or Military Identification Card. If the applicant does not fall into one of these categories, an Affidavit to Release a Birth Certificate must be completed by an authorized person and submitted with the application.

  2. Who is eligible to request a birth certificate?

    Birth certificates can be issued to specific individuals, including:

    • The registrant (the child named on the record) if they are 18 years or older.
    • Parent(s) listed on the birth record.
    • Legal guardians, who must provide guardianship papers.
    • Legal representatives of any of the above individuals.
    • Other persons who have a court order, which must be a recorded or certified copy.

    In cases where the registrant is deceased, the spouse, child, grandchild, sibling (if of legal age), or legal representative of these individuals can request a certification of the birth certificate upon providing the death certificate.

  3. 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 (non-refundable fee for the birth record search).
    • Additional Certified Copy (same person, same day): $8.00.
    • Protective Plastic Sleeve: $2.00.
    • Fax or Mail Rush Orders: $5.00.
    • Optional FedEx Delivery: $17.00 (not available for PO/APO Boxes).
    • Optional Notary Services (for amendment forms only): $10.00.

    Payment can be made via check, money order, or credit card (Visa, Mastercard, Discover, or Amex).

  4. How can I obtain a birth certificate if the record is under seal?

    For birth records that are under seal due to adoption, paternity determination, or court order, the application process is different. To request a record under seal, you must write to the Bureau of Vital Statistics at the following address:

    Bureau of Vital Statistics
    Attn: Records Amendment Section
    P.O. Box 210
    Jacksonville, FL 32231-0042

    Make sure to include any necessary documentation that supports your request.

  5. What should I do if I need a birth certificate for someone else?

    If you need to request a birth certificate for someone other than yourself, you must demonstrate your eligibility. This may involve providing documentation such as a court order or proof of guardianship. Be sure to fill out the application completely, indicating your relationship to the registrant. If you are a legal representative, include your attorney bar number and specify whom you represent.

Common mistakes

Completing the Florida Birth Certificate application can be straightforward, but mistakes often occur. One common error is failing to provide valid photo identification. The application requires a valid ID for the applicant, whether they are the registrant, parent, guardian, or legal representative. If submitting by mail, a copy of this identification must also be included. Omitting this crucial step can lead to delays or outright rejection of the application.

Another frequent mistake involves incorrect or incomplete registrant information. Applicants must fill out the child's full name as it appears on the birth record, including any suffixes. If the name has changed since birth, it is essential to indicate the new name clearly. Neglecting to provide accurate details can complicate the verification process and may result in additional fees or a need to resubmit the application.

Many applicants also overlook the requirement to specify their relationship to the registrant. This section is critical for verifying eligibility to obtain the birth certificate. If someone is ordering the certificate on behalf of another person, they must clearly state their relationship. Failing to do so can lead to confusion and delays in processing the request.

In addition, misunderstanding the fee structure can lead to issues. The application includes various fees for certified copies, protective sleeves, and expedited services. Applicants must ensure they submit the correct payment based on their needs. If the total amount is not accurate, it may result in processing delays or rejection of the application.

Another common error is not signing the application. The applicant's signature is required, along with their printed name, residence address, and telephone number. Neglecting to sign the application can cause it to be deemed incomplete, leading to further delays.

Lastly, applicants sometimes forget to review the entire application before submission. It is crucial to read both the front and back of the application thoroughly. This review helps ensure that all requirements are met and that no information is missing. Taking the time to double-check can save significant time and effort in the long run.

Documents used along the form

The process of obtaining a Florida birth certificate often involves several other important forms and documents. Each of these serves a specific purpose and may be necessary depending on individual circumstances. Below is a list of commonly used documents that accompany the Florida Birth Certificate application.

  • Affidavit to Release a Birth Certificate (DH Form 1958): This form is required if the applicant is not the registrant, parent, guardian, or legal representative. It must be completed by an authorized person to allow the release of the birth certificate.
  • Valid Photo Identification: Applicants must provide a valid form of photo ID, such as a driver’s license or passport, when submitting the birth certificate application. This ensures the identity of the requester is verified.
  • Guardianship Papers: If the applicant is a legal guardian, they must submit documentation proving their guardianship status along with the application.
  • Death Certificate: In cases where the registrant is deceased, a death certificate must be provided. This allows eligible family members to obtain a certified copy of the birth record.
  • Court Order: If someone other than the registrant, parent, or guardian is requesting the birth certificate, a court order must be included. This document grants permission for the release of the record.
  • Application for a Certified Copy of a Birth Record: This is the primary form that must be completed to request a certified copy of the birth certificate, detailing all necessary information about the registrant.
  • Payment Method: A payment method must be included, whether it’s a check, money order, or credit card information, to cover the fees associated with obtaining the birth certificate.
  • Notary Services Request: If the applicant requires notary services for any amendment forms, this request should be included with the application for timely processing.
  • Contact Information: The applicant must provide their contact information, including a phone number and mailing address, to ensure proper communication during the application process.

Understanding these additional forms and documents can help streamline the process of obtaining a Florida birth certificate. Each document plays a crucial role in ensuring that the application is complete and that the request is handled efficiently. Being prepared with the necessary paperwork can save time and avoid potential delays.

Similar forms

The Florida Birth Certificate form shares similarities with several other important documents. Here’s a list of nine documents that are comparable, each serving a unique purpose while containing essential personal information.

  • Social Security Card: This document provides a unique identifier for individuals in the U.S. It includes the person's name and Social Security number, similar to how a birth certificate identifies an individual by name and date of birth.
  • Driver’s License: A driver’s license serves as a government-issued identification that includes personal details such as name, address, and date of birth, much like a birth certificate does.
  • Passport: A passport is an official document that verifies identity and nationality, containing the holder's name, date of birth, and photo, paralleling the identification purpose of a birth certificate.
  • Marriage Certificate: This document records the union between two individuals, including their names and the date of marriage, akin to how a birth certificate records a person's birth details.
  • Divorce Decree: A divorce decree outlines the dissolution of a marriage and includes names and dates, similar to how a birth certificate includes identifying information about an individual.
  • Adoption Certificate: An adoption certificate legally recognizes the adoption of a child and includes names and birth information, paralleling the birth certificate’s role in documenting birth events.
  • Naturalization Certificate: This document confirms an individual's citizenship status and includes personal details such as name and date of birth, just as a birth certificate does for birth details.
  • Health Insurance Card: A health insurance card provides essential information about the insured individual, including their name and policy number, similar to how a birth certificate identifies a person.
  • Voter Registration Card: This card verifies an individual's eligibility to vote, including their name and address, much like a birth certificate verifies identity and personal details.

Each of these documents plays a crucial role in establishing identity and legal status, just as the Florida Birth Certificate does. Understanding these similarities can help clarify the importance of maintaining accurate personal records.

Dos and Don'ts

When filling out the Florida Birth Certificate form, consider the following guidelines to ensure a smooth application process.

  • Do read the entire application, both front and back, to understand all requirements.
  • Do provide valid photo identification if you are the applicant or a legal representative.
  • Do clearly indicate your relationship to the registrant in the application.
  • Don't submit the application without the required payment; fees are nonrefundable.
  • Don't provide false information on the application, as this is a felony.
  • Don't forget to sign the application; an unsigned application will be rejected.

Misconceptions

Understanding the Florida Birth Certificate form can be challenging, leading to some common misconceptions. Here are four of them:

  • Anyone can request a birth certificate. This is not true. Only specific individuals, such as the registrant, parents, or legal guardians, can obtain a birth certificate. Others may need a court order.
  • Photo identification is optional. In fact, valid photo identification is a requirement for applicants who are self, parent, guardian, or legal representative. Without it, the request cannot be processed.
  • All birth records are available without restrictions. Some records are sealed due to adoption or court orders. These cannot be requested through the usual process and require a different approach.
  • Fees for birth certificate applications are refundable. This is a misconception. The fees are nonrefundable, regardless of the outcome of the application.

By clarifying these points, individuals can better navigate the process of obtaining a Florida birth certificate.

Key takeaways

  • To obtain a Florida birth certificate, applicants must complete the application form and provide valid photo identification. Acceptable forms of ID include a driver's license, state ID card, passport, or military ID.

  • If the applicant is not the registrant, parent, guardian, or legal representative, an Affidavit to Release a Birth Certificate must be submitted by an authorized person.

  • Birth certificates can only be issued to eligible individuals, including the registrant (if 18 or older), parents listed on the record, legal guardians, or legal representatives.

  • In cases where the registrant is deceased, the birth certificate can be issued to certain family members or their legal representatives, provided the death certificate is included with the request.

  • Applications must be submitted with the appropriate fees. The first certified copy costs $13.00, while additional copies of the same record are $8.00 each.

  • Vital record fees are nonrefundable. A verification of eligibility will occur before the nonrefundable search fee is charged.

  • For records under seal, such as those related to adoption or court orders, a separate request must be sent to the Bureau of Vital Statistics.