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Get Harlingen Vital Statistics

0 PLASTIC POUCH $1.00 EXTRA PLEASE PRINT 1. NAME ON RECORD MIDDLE FIRST 2. DATE OF BIRTH LAST FEMALE MONTH MALE YEAR DAY 3. PLACE OF BIRTH CITY 4. FATHER'S NAME FIRST MIDDLE LAST 5. MOTHER'S NAME FIRST MIDDLE (MAIDEN NAME ONLY) 7. TELEPHONE# ( 6. APPLICANT'S NAME ) Applicant's (your) Information (Your relationship to the person whose certificate you want) Parent (Government Issued Picture(Current) ID REQUIRED (not a copy), must be listed on certificate) Self (Government i.

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