Birth Records Request Form

Your Name*

First Last

Your Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Phone*

Your Email*

What name should be on the birth record?*

Alternate spellings for the name?

Date of birth. Please provide as much information as you have. If you do not have an exact date, please provide a maximum 5-year range for us to search.*

Where do you think the family was living? What supporting information do you have that may confirm that?*

Names of parents (if available)

Names of known siblings (if available). This can help us confirm family groupings.

Reason for record request?*

General research
Dual citizenship application (we will provide certified/notarized hard copies)

What religion did the family practice? If we cannot find a record, we will try to point you toward the appropriate church or religious archives.

Are you requesting these documents be mailed to a non-US address or by a method other than domestic first-class mail?*

Yes
No

Documents mailed to a non-US address or by a method other than domestic first-class mail will incur mailing charges based on the shipping method.*

I understand and will pay shipping costs prior to documents being sent.

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Birth Records Request

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