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Birth Certificate Application


  1. 1. #1
  2. 2. Child's Information on Birth Record
  3. 3. Parent Information on Birth Record
  4. 4. Shipping Address
  5. 5. Your Relationship
  6. 6. Certificate Size
  • #1

    1. You Understand That Your Order Will not be Processed Without Faxing or Emailing your ID and Proper Documentation.*

      Fax: 765-423-9797 Email: