Get Kansas Birth Certificate

K. S.A. 65-2422d Parents Adult Children Grandparents Siblings Aunts/Uncles Niece/Nephew Must be age 18 or older If legal guardianship has been established through the courts please provide a copy of the guardianship papers. If you do not have a government issued photo ID you must send photocopies of any two of the following Photocopies must be of the complete document able to be read and be the Requestor s with current address Temporary Driver s License Social Security card must be signed by card holder Bank Statement with Requestor s current address Car Registration or Title with Requestor s current address Utility Bill with current address of Requestor and company letterhead with company name and address not handwritten Current Pay Stub must include your name social security number plus name and address of business not handwritten Valid insurance card or policy of Requestor Valid health insurance card or policy of Requestor Parole document book sheet of Requestor Bureau of Indian Affairs Tribal ID card of Requestor Inmate ID of Requestor along with a memo completed and signed by a counselor or parole officer Filed Income Tax of Requestor with current address Letter to Requestor from Social Service Agency/Health Department or other government agency with current address Hospital or Health agency bill with current address of Requestor Court Documents of Requestor W-2 from Employer with Requestor s current address Letter from employer with Requestor s current address U.S. Voters registration card of Requestor Adoption When an adoption has occurred the biological family may not have a legal right to the adoptee s record nor may the adoptee have a legal right to the biological family s records. Make checks or money orders payable to Kansas Vital Statistics. For your protection do not send cash. Birth Information Name on birth Certificate Date of Birth Race Place of Birth Sex City County State must be in Kansas Hospital of Birth Date of Death Current Age of this person If Applicable Full Maiden name of Mother Birthplace of Mother Full Name of Father/Parent 15 per certified copy Number of copies ordered Adopted Total Adoption Information Yes No Is request for record before adoption Name Change If certificate name has changed since birth other than adoption or marriage please list changed name here Provide before adoption name below Requirements-Read before turning in application OFFICE USE ONLY 1 This request form must be completed. Type/ID 2 Enclose a copy of both front and back of a current legal photo ID see back for list of acceptable ID s Station/ of apps Exp 3 Enclose appropriate fees Amount given 5 If submitting by mail enclose a self-addressed stamped envelope Request will be returned if the above steps are not completed correctly Walk-in Hours Mon-Fri 9 00 a.m-4 00p.m. Payment Type CASH CHECK Chg provided CCARD MO INITIAL Kansas Office of Vital Statistics 1000 SW Jackson Suite 120 Topeka KS 66612-2221 Office hours Mon-Fri 8 00a.m.-5 00 p.m. Phone 785-296-1400 VS-235 4/16 Detailed Information Identification Requestor s current ID required To Get a Certificate Who s Eligible to Obtain Most Certificates Must provide ID and proof of direct interest ONE form of Primary Documentation required from list below Eligibility Please make a copy of one of the following documents and send with the application. All documents MUST be signed current and valid. All Identification must have both sides and be able to be read. Photocopy of Government Issued Driver s License Military ID State ID card Valid Passport and Visa s. Birth Information Name on birth Certificate Date of Birth Race Place of Birth Sex City County State must be in Kansas Hospital of Birth Date of Death Current Age of this person If Applicable Full Maiden name of Mother Birthplace of Mother Full Name of Father/Parent 15 per certified copy Number of copies ordered Adopted Total Adoption Information Yes No Is request for record before adoption Name Change If certificate name has changed since birth other than adoption or marriage please list changed name here Provide before adoption name below Requirements-Read before turning in application OFFICE USE ONLY 1 This request form must be completed. Type/ID 2 Enclose a copy of both front and back of a current legal photo ID see back for list of acceptable ID s Station/ of apps Exp 3 Enclose appropriate fees Amount given 5 If submitting by mail enclose a self-addressed stamped envelope Request will be returned if the above steps are not completed correctly Walk-in Hours Mon-Fri 9 00 a.m-4 00p.m. Payment Type CASH CHECK Chg provided CCARD MO INITIAL Kansas Office of Vital Statistics 1000 SW Jackson Suite 120 Topeka KS 66612-2221 Office hours Mon-Fri 8 00a.m.-5 00 p.m. Phone 785-296-1400 VS-235 4/16 Detailed Information Identification Requestor s current ID required To Get a Certificate Who s Eligible to Obtain Most Certificates Must provide ID and proof of direct interest ONE form of Primary Documentation required from list below Eligibility Please make a copy of one of the following documents and send with the application. All documents MUST be signed current and valid. All Identification must have both sides and be able to be read. Photocopy of Government Issued Driver s License Military ID State ID card Valid Passport and Visa s. Not the credit/debit card Permanent resident card Alien registration receipt card Employment authorization card Re-entry permit Refugee Travel Document VA Card with intact photo Voter s registration card Countries outside of the U.S. Certificate of Naturalization with intact photo Resident Alien card Concealed Carry handgun license PLEASE NOTE MATRICULAS ARE NOT AN ACCEPTABLE FORM OF ID By State law vital records filed with this office are not open for public inspection and the requestor must meet eligibility requirements -- must be named on the record an immediate family member or someone who can provide legal proof the record is necessary for the determination of personal or property rights. S.A. 65 2422d. g. Vital records identity theft related to obtaining certificates or making counterfeiting altering amending any certified copy of a vital record with the intent to sell or obtain for any purpose of deception a certified copy of a vital record is a severity level 8 nonperson felony. Application for Certified Copy of Kansas Birth Certificate PLEASE NOTE BIRTH CERTIFICATES ARE ON FILE FROM JULY 1 1911 TO PRESENT Name of Requestor Today s Date person requesting the certificate Address City/State Zip Email Reason for Request PLEASE BE SPECIFIC Phone Number Signature of Requestor IMPORTANT The person requesting the vital record must submit a copy of their identification. See list on reverse side. WARNING COPYING ALTERING or FRAUDULENT ACTIVITY PROHIBITED Except as authorized by the Uniform Vital Statistics Act no person shall prepare or issue any certificate vital record which purports to be an original certified copy or abstract or copy of a certificate K. 00. IF THE CERTIFICATE IS NOT LOCATED A 15. 00 FEE MUST BE RETAINED BY THIS DEPARTMENT FOR THE RECORD SEARCH. Make checks or money orders payable to Kansas Vital Statistics. For your protection do not send cash. Relationship to person on the Certificate Check one Maternal Grandparent Father Brother Legal Guardian submit custody order Son Other specify Daughter Self Mother Sister Current Spouse Paternal Uncle Paternal Aunt Fees K.