PAGE 1 OF 2 OFFICE OF VITAL RECORDS 0 3 / 2024
Birth Certificate Request
Use this form to order a birth certificate for a person born in Minnesota. If we cannot find the birth record you request, we
will send you a certified Statement of No Birth Record Found. NOTE: County offices generally provide the fastest vital
records service; in-person requests can often be fulfilled while you wait. It’s illegal to give false information to obtain a
vital record, and it may subject you to fines, jail time, or both. (Minnesota Statutes 144.227)
Information to find the requested birth record
Minnesota Rules 4601.2600
Child/subject middle name
Date of birth (MM/DD/YYYY)
☐ Female
Minnesota county of birth
Last name before 1
st
marriage
Last name before 1
st
marriage
REQUIRED – Requester information
Minnesota Rules 4601.2600
Date of birth (MM/DD/YYYY)
(Express delivery will not deliver to PO boxes or APO addresses.)
REQUIRED — Mark the boxes that describe your relationship to the subject of the record
Minnesota Statutes 144.225
Marital status is important.
Records of children born to married parents are “public”. That means that the certificate is available to those listed in items 1 – 18
below. Records of children born to single mothers are “confidential” unless the mother chose to make the record public at the time of
birth. Only the persons listed below in items 19 – 23 may obtain confidential birth certificates.
“Public” birth records are available to individuals who meet any of the legal requirements in items 1-18
☐
A parent named on the subject’s record
☐
A grandparent of the subject
☐
A great grandparent of the subject
☐
☐
A grandchild of the subject
☐
A great-grandchild of the subject
☐
Spouse of the subject (You must be the current spouse)
8. ☐ I am the subject; I am requesting my own birth record
9.
☐ The legal custodian, guardian, or conservator of the subject (we need a certified copy of the court order that names you)
10.
☐ The health care agent for the subject (we need a valid “health care power of attorney” document)
11.
☐ Subject’s personal representative (we need a notarized statement that says you need the birth certificate to administer the estate)
12.
☐ Successor of the subject (subject is dead) (we need a notarized statement that says you need the birth certificate to administer the estate)
☐
Proof that you need a birth certificate for the determination or protection of a personal or property right
☐
Adoption agency — to complete post-adoption search (we need a copy of your Employee ID)
☐
Local/state/tribal or federal governmental agency (we need a copy of your Employee ID) (Best practice: wait for family to verify record)
☐
Attorney – I represent the subject, or a person listed in items 1-14 above.
My Minnesota Attorney License Number is:
If you are a NON-Minnesota attorney, attach a
copy of your attorney license.
☐
Pursuant to a valid, certified copy of a U.S. court order (not a subpoena) releasing the certificate
18.
☐ I have a signed statement from a person above; it specifies the subject’s full name, date of birth, parents’ names, the signer’s
relationship to the subject of the record and it authorizes me to obtain the certificate.
“Confidential” birth records are available only under the conditions, or to the person, in items 19-23
☐
Parent named on the subject’s record
20.
☐ The legal custodian, guardian, or conservator of the subject (you need a certified copy of a court order naming you)
21.
☐ The subject, when 16 years old or older
22.
☐ Representatives of Minnesota programs that administer child support, medical assistance, MinnesotaCare, and services under
Minnesota Statutes, sections 124D.23; Minnesota Statutes, chapter 260E; and, tribal child support programs, Minnesota
Statutes, section 144.225, subdivision 2, paragraph (f). (we need a copy of your Employee ID)
☐
Pursuant to a valid, certified copy of a U.S. court order (not a subpoena) releasing the certificate