Birth/Death Certificate Informational Copies Order Form

Instructions for Birth/Death Certificate Informational Copies Order Form

Carefully read these instructions before completing and submitting the Birth/Death Informational Copies Order Form. Chapter 70.58A RCW and Chapter 246-491 WAC requires applicants to provide required information to order noncertified informational copies of birth and death records.

Checklist for completing the Birth/Death Certificate Informational Copies Order Form:

•Complete all fields on the informational copies form

What is a noncertified informational copy?
Noncertified informational copies of birth and death records are not issued on the certified paper with security features and cannot be used for legal purposes. It will contain a watermark stating “Cannot be used for legal purposes. Informational only.”

Check with the agency or business about whether they will accept informational copies prior to purchasing a noncertified informational copy.

Informational copies of birth records contain the same information as a certified birth copy.

Informational copies of death records contain the same information as the certified short form death copy. It does not contain cause and manner of death information or social security number of the decedent.

Noncertified informational copy of long form death, fetal death, marriage, or divorce records are not available.

What information is required for noncertified informational copy of birth records?
The following information is required as it appears on the birth record:
•First, middle, and last name of the subject of the record
•First and last name of all parents listed on the record
•Date of birth (month, date, year)
•City or county where the birth occurred

What information is required for noncertified informational copy of death records?
The following information is required as it appears on the death record:
•First and last name of the decedent
•Approximate date of death (month and year)
•City or county where the death occurred

Requestor Information

NAME OF PERSON ORDERING CERTIFICATE(S):

Requestor First Name *

Requestor Last Name *

Mailing Address *

City *

State *

Zip Code *

Email Address *

Phone Number *

NONCERTIFIED INFORMATIONAL COPIES OF BIRTH AND DEATH RECORDS ARE NOT ISSUED ON CERTIFIED PAPER AND CANNOT BE USED FOR LEGAL PURPOSES. COPIES WILL CONTAIN A WATERMARK STATING THAT IT IS FOR INFORMATIONAL PURPOSES ONLY. THE INFORMATIONAL DEATH COPY WILL NOT DISPLAY CAUSE AND MANNER OF DEATH OR DECEDENT’S SOCIAL SECURITY NUMBER.

I have read and agree to the above statements. *

Yes

Birth Records Details

FIRST NAME ON CERTIFICATE

FULL MIDDLE NAME ON CERTIFICATE

LAST NAME ON CERTIFICATE

DATE OF BIRTH (mm/dd/yyyy) +

CITY OF BIRTH

STATE OF BIRTH

MOTHER/PARENT FIRST NAME

MOTHER/PARENT MIDDLE NAME

MOTHER/PARENT MAIDEN LAST NAME

FATHER/PARENT FIRST NAME

FATHER/PARENT MIDDLE NAME

FATHER/PARENT LAST NAME

Death Records Details

FIRST NAME

FULL MIDDLE NAME

LAST NAME

DATE OF DEATH (mm/dd/yyyy) +

CITY OR COUNTY OF DEATH

OTHER NAMES (EX. MAIDEN NAME, MARRIED NAMES)

SPOUSE(S), IF KNOWN

DATE OF BIRTH, IF KNOWN +

PLACE OF BIRTH, IF KNOWN

Order Information

Informational Copies cost $25.00 each

Online orders process and ship via standard United States Postal Service mail within 3-7 business days after we receive full payment and all required documentation. Missing information or documentation will delay orders.

Fee for debit/credit card transactions is $2.00 or 2.35% (whichever is greater)

SELECT THE TOTAL NUMBER OF
CERTIFIED INFORMATIONAL
CERTIFICATE COPIES *

Current Total:

$0.00

Payment

Fee for debit/credit card transactions is $2.00 or 2.35% (whichever is greater)

Credit Card Type

Name on Card

Credit Card Number

Expiration Date

CVV

Office Use Only

Authorization #

Today's Date * +

Order Status