This document is an application for a certified copy of a birth certificate from the Commonwealth of Kentucky State Registrar of Vital Statistics. It requests information to identify the birth certificate being requested such as the name on the certificate, date of birth, place of birth, parents' names, and the requestor's relationship and contact information. It provides instructions on submitting the application via mail with payment and notes that certificates can also be ordered online, by phone, or by walking into the office. The fee for a certified copy is $10 with additional copies at $10 each.
This document is an application for a certified copy of a birth certificate from the Commonwealth of Kentucky State Registrar of Vital Statistics. It requests information to identify the birth certificate being requested such as the name on the certificate, date of birth, place of birth, parents' names, and the requestor's relationship and contact information. It provides instructions on submitting the application via mail with payment and notes that certificates can also be ordered online, by phone, or by walking into the office. The fee for a certified copy is $10 with additional copies at $10 each.
This document is an application for a certified copy of a birth certificate from the Commonwealth of Kentucky State Registrar of Vital Statistics. It requests information to identify the birth certificate being requested such as the name on the certificate, date of birth, place of birth, parents' names, and the requestor's relationship and contact information. It provides instructions on submitting the application via mail with payment and notes that certificates can also be ordered online, by phone, or by walking into the office. The fee for a certified copy is $10 with additional copies at $10 each.
This document is an application for a certified copy of a birth certificate from the Commonwealth of Kentucky State Registrar of Vital Statistics. It requests information to identify the birth certificate being requested such as the name on the certificate, date of birth, place of birth, parents' names, and the requestor's relationship and contact information. It provides instructions on submitting the application via mail with payment and notes that certificates can also be ordered online, by phone, or by walking into the office. The fee for a certified copy is $10 with additional copies at $10 each.
(Rev 9/1/2018) COMMONWEALTH OF KENTUCKY STATE REGISTRAR OF VITAL STATISTICS
BIRTH APPLICATION FOR A CERTIFIED COPY OF BIRTH CERTIFICATE
Certificates of Birth that occurred in Kentucky since 1911 are on file in this office
Please Print or Type Sections 1 through 13. RESET
BIRTH CERTIFICATE INFORMATION 1. Full Name at Birth First Middle Last
2. Date of Birth Month Day Year Sex Age Last Birthday
Kentucky City or Town Kentucky County Name of Hospital
3. Place of Birth
4. Mother’s Maiden First Middle Last
Name
First Middle Last
5. Father’s Name
6. If this child has been adopted, please give First Last
original name if known 7. What is your relationship to the person whose certificate is being Relationship requested? First Last 8. Requestor’s Printed Name
Phone Number With Area Code
9. Requestor’s Phone Number
Street Address 10. Requestor’s Printed Street Address
11. Requestor’s City, State, Zip City, State, Zip
12. Requestor’s Signature
DO NOT WRITE IN THIS SPACE 13. FEES – NON REFUNDABLE
A fee is to be paid for certified copies or records, or for a search of the files or records when Volume no copy is available. The fee for a certified copy of a birth certificate is $10.00 U.S. Certificate Additional copies are $10.00 U.S. each. Make check or money order payable to “Kentucky Year State Treasurer.” This fee is non refundable. Date ________ Certified Copies @ $10.00 each = $ Searched by How many Total payment
Certificates may also be ordered by the following methods:
Internet: Certificates may be ordered on the internet using a credit card (Visa, MasterCard, Discover or American Express) or check. An additional charge card fee will apply. This is in addition to the fee for each certified copy requested. Certificates requested via internet at this website: www.vitalchek.com/kentucky-xpress-birth-certificates.aspx may be returned by overnight courier for an additional shipment fee (if that record is available).
Telephone: Orders may be placed by telephone using a credit card (Visa, MasterCard, Discover or American Express) or check. An additional processing fee will apply. This processing fee is in addition to the fee for each certified copy requested. Certificates requested via telephone may be returned by overnight courier for an additional fee. The telephone number to place your order is (800) 241-8322, choose option 1.
Mail: Orders are accepted by mail, using a check or money order in U.S. dollars drawn on a U.S. bank for payment. It can take up to 30 working days to process your request from the date payment is posted. Mail application and payment to Vital Statistics, 275 East Main Street 1E-A, Frankfort, KY 40621. The Office of Vital Statistics telephone number is (502) 564-4212.
Walk-in: You may order a certified copy of the birth record by coming to this office. The office is located at the address above. Orders are accepted for same day issuance from 8:00 AM until 3:30 PM Monday through Friday.
