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Birth Certificate Application

  1. As it appears on birth record
  2. Sex
  3. Certification
  4. Tangible Intrest Required for a Certified Copy
    I am the:
  5. Penalties
    Any person who willfully and knowingly makes false application for a birth certificate is guilty of a misdemeanor or gross misdemeanor (MN Statutes, section 144.227, subdivision 1).
  6. The following information is about the person completing this application.
  7. I certify that the information provided on this application is accurate and complete to the best of my knowledge.
  8. Only requests for certified copies require notarization if applying by mail or fax.
  9. Leave This Blank: