- Application for Certified Copy of Birth Certificate - West Virginia
- Birth Certificate Request - Washington D.C.
- Birth Certificate Order Form - Alameda County
- Application for Birth/Death Certificate - Louisiana
- Birth Certificate Request Form - Georgia
- Birth / Death Certificate Mail Order Form - Washington
Fillable Printable Vital Statistics Certificate Request Form - Idaho
Fillable Printable Vital Statistics Certificate Request Form - Idaho
Vital Statistics Certificate Request Form - Idaho
IDAHO VITAL STATISTICS CERTIFICATE REQUEST
Instructions for completing this form are located on the back of this document. Please read these instructions carefully. Failure to
do so may cause a significant delay in processing your request.
YOUR MAILING ADDRESS INFORMATION (PERSON REQUESTING THE CERTIFICATE)
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME
STREET AND NUMBER (P.O. BOX) CITY, STATE ZIP CODE
CONTACT PHONE NUMBER (DAYTIME) YOUR RELATIONSIP TO THE PERSON NAMED ON THE CERTIFICATE (SELF,MOTHER, ETC.)
PURPOSE FOR THE CERTIFICATE
INCLUDE COPY OF ACKNOWLEDGEMENT OF
PATERNITY WITH BIRTH CERTIFICATE.
SIGNATURE OF THE PERSON REQUESTING THE CERTIFICATE:
►
IMPORTANT: BIRTH, DEATH, STILLBIRTH, MARRIAGE OR DIVORCE MUST HAVE OCCURRED IN IDAHO
INDICATE CERTIFICATE EVENT REQUESTED: BIRTH
STILLBIRTH
DEATH
Available from July, 1911
NAME ON THE CERTIFICATE
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME
DATE OF EVENT CITY OF EVENT NUMBER OF COPIES YOU ARE REQUESTING
MOTHER
FATHER
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME MAIDEN NAME
MOTHER
FATHER
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME MAIDEN NAME
INDICATE CERTIFICATE EVENT REQUESTED: MARRIAGE
DIVORCE
Available from May, 1947
BRIDE/WIFE GROOM/HUSBAND
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME (AT THE TIME OF THE EVENT)
BRIDE/WIFE GROOM/HUSBAND
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME (AT THE TIME OF THE EVENT)
DATE OF EVENT CITY OF EVENT NUMBER OF COPIES YOU ARE REQUESTING
ORDER TOTALS
DESCRIPTION OF ITEM
FEES
#OF
COPIES
TOTAL
COST
BIRTH-STILLBIRTH-MARRIAGE-DIVORCE-DEATH CERTIFIED COPY (COMPUTER GENERATED) $16.00
BIRTH-STILLBIRTH-MARRIAGE-DIVORCE-DEATH CERTIFIED PHOTOCOPY
ADDITIONAL PHOTOCOPIES OF THE SAME CERTIFICATE EVENT
$21.00
$16.00
SPECIAL HANDLING (RUSH ORDERS ONLY) PER EVENT REQUESTED
$10.00
TOTAL ENCLOSED
* See the back of this document for further instructions, information, and explanation of fees.
♦
If you would like to RUSH your order, please include a one-time charge of $10.00 (per event) and write RUSH on the outside of your
envelope. There is no shipping charge for regular mail. If express mail is desired, you may express mail your request to us and include a
prepaid express mail envelope back to yourself. We cannot send your order C.O.D.
PLEASE READ THESE INSTRUCTIONS CAREFULLY
07-01-2015
WHO CAN ORDER
O
nly immediate family members, their legal representative, or those who provide documentation showing it is needed for their
property right may order legally confidential certificates. Immediate family includes: spouse, sibling, parent, child, grandparent,
and grandchild.
Proof of relation/legal representation may be required. Step-relatives, in-laws, great-grandparents, aunts, uncles, cousins, etc.
are not immediate family as defined by Idaho Statute.
IDENTIFICATION IS REQUIRED
The applicant (person signing this request) must provide a photocopy of their driver’s license or other current signed government
[state, federal or tribal] issued picture identification. If this is not available, copies of two other forms of identification are required;
one of which MUST include the applicant’s signature. (Refer to the following list) ID is accepted upon validity verification by
our office.
IMPORTANT: If acceptable identification is NOT enclosed, and/or your application is incomplete, your request will be returned
and significant delays in processing your order may occur.
APPROVED IDENTIFICATION LIST
Current
Government
Issued Picture
Identification
with a signature
OR Two Forms of CURRENT ID – One MUST have a Signature OR
•
Driver’s License
•
State ID Card
•
Passport
•
Tribal ID Card
•
Concealed
Weapons
Permit
•
Prison ID Card
•
Social Security Card with signature
•
Work ID Card with picture or signature
•
Auto registration with signature
•
Traffic Ticket with signature
•
Court Record with signature
•
College/School ID with picture
•
Matricula Card with signature.
•
Insurance Record
•
Auto Insurance
•
Driver Permit
•
Pay stub
•
Hunting/Fishing License
•
Passport Card
•
Notarized Signature on
the Request
•
Have an immediate
family member (that
has current ID from the
approved list) request it
for you (Please Note:
Proof of relation may
be required.)
•
Court Order
FEES
CERTIFICATE FEES
Each certified copy or record search of a Birth, Stillbirth, Death, Marriage or Divorce Certificate is $16.00. Certified copies are
computer-generated and are valid for most legal purposes. If the requested certificate cannot be found a statement of search will
be issued. A certified photocopy (not computer-generated) of a Birth, Stillbirth, Death, Marriage or Divorce certificate can be
ordered for $21.00; each additional certified photocopy of that record, ordered at the same time, is $16.00.
LEGAL FEES
The Processing fee to complete an adoption, paternity, or court order name change is $20.00. The processing fee to complete a
delayed registration is $25.00. (Does not include a copy of the certificate).
RUSH FEES
If you would like to RUSH your order, please include a one-time charge of $10.00 (per event) and write RUSH on the outside of
your envelope. If you would like to RUSH your legal action, please include a one-time charge of $25.00 (per event). There is no
shipping charge for regular mail. If express mail is desired, you may express mail your request to us and include a prepaid
express mail envelope back to yourself. We cannot send your order C.O.D.
To order on-line, through VitalChek, please see our website at http://www.vitalrecords.dhw.idaho.gov. Additional charges will
apply. All credit card orders are processed through Vitalchek.
Make checks or money orders payable to Idaho Vital Records.
SUBMITTING THE REQUEST
Complete the request form and mail it to the address on the front of the form. Remember to sign your request and
enclose the correct fees and a copy of both sides of your signed picture ID.
WARNING: False application for a certified copy of a vital record is a felony punishable by a fine up to
$5,000, five years in prison, or both (Title 39, Chapter 2, Idaho Code).
