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  • Pa H105.102 2020

Get Pa H105.102 2020

Application for a Birth Certificate H105. 102 REV 06/18 BIRTH INTERNAL USE ONLY Initials Date Delivery Print or Type P PO M S R A PART 1 APPLICANT My current legal name First Middle Street Last Suffix Email address City Zip code State Daytime phone Applicants must be 18 years of age or older or an emancipated minor to apply. MY RELATIONSHIP TO PERSON NAMED ON BIRTH RECORD Intended use of birth certificate Social Security/benefits Travel/passport School Driver s license Dual citizenship Employment Other PART 2 BIRTH CERTIFICATE BEING REQUESTED Please complete as much information as possible. Please specify other reason. AGE NOW NAME AT BIRTH If name has changed since birth due to adoption court order or any reason other than marriage please list that name here TYPE OF BIRTH RECORD DATE OF BIRTH SEX Male Female PLACE OF BIRTH Born in Pennsylvania City/borough/township County Hospital name PARENT/MOTHER S NAME Last name prior to first marriage Current last PART 3 ACCEPTABLE FORMS OF IDENT....

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How to fill out the PA H105.102 online

The PA H105.102 form is essential for individuals seeking a certified birth certificate in Pennsylvania. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete the PA H105.102 form online:

  1. Click the ‘Get Form’ button to access the PA H105.102 form and open it in your preferred online editor.
  2. In Part 1, fill in your current legal name. Be sure to include your first name, middle initial, last name, and any suffix, if applicable. Provide your email address, zip code, state, city, and daytime phone number. Remember, applicants must be 18 years of age or older, or an emancipated minor.
  3. Indicate your relationship to the person named on the birth record. You can select from options such as social security, travel, school, and others based on your intended use of the birth certificate.
  4. In Part 2, enter the name at birth of the individual as it appears on their birth certificate. This includes their first, middle, last, and any suffix. If the name has changed since birth, provide the changed name.
  5. Specify the type of birth record you are requesting and enter the individual's sex, date of birth, place of birth, and the names of their parents in Part 2.
  6. In Part 3, indicate what form of identification you have included with your application. If you do not have a valid photo ID, provide two current documents that verify your name and address.
  7. Part 4 requires you to calculate the total fee. If applying by mail, ensure to submit a check or money order. If applying in person, various payment methods are accepted.
  8. In Part 5, provide your signature and date. Your signature should match the name you listed in Part 1. Review your entries to ensure all information is complete and accurate.
  9. Once you have filled out all sections of the form, save your changes. You can then download, print, or share the completed form as needed.

Complete your application for a birth certificate online today.

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If you completed the AOP at time of your child's birth but the birth certificate does not list the father, please follow up with DHS at 800-932-0211. Once you have verified that DHS has processed your AOP, complete an Application to Add a Father to a Birth Record.

A name change correction for a child is simple, if the birth certificate was issued in Pennsylvania and both biological or adoptive parents consent to the change of name. Both of the biological parents must complete and sign the form on the back of their child's birth certificate in the presence of a notary.

A Father can apply to have his details added to his child's birth certificate. The applicant would need to submit a Court Order naming him as the father of the child along with a completed and signed prescribed form from the local Civil Registration Office for approval by the Regional Superintendent Registrar.

Add Father's Name to Birth Certificate of Child You may request a change to a birth certificate to add the father of a child by completing a request form indicating the changes to be made. Note: The child's name may also be changed when the father's name is added to the birth certificate.

Complete a birth certificate application or death certificate application. Completed and signed applications with ID and payment should be mailed to the Division of Vital Records, P.O. Box 1528, New Castle, PA 16103.

Complete a birth certificate application or death certificate application. Completed and signed applications with ID and payment should be mailed to the Division of Vital Records, P.O. Box 1528, New Castle, PA 16103.

Results of the DNA-based parentage test (paternity test) approved by National Association of Testing Authorities (NATA) (External link) A court order directing BDM to add a parent to the birth certificate.

If you need a birth certificate quickly, make your request in person at one of our six Vital Records Branch Offices or online at www.vitalchek.comOpens In A New Window. See our Processing Times for current processing times for applications placed online, by telephone or by mail.

Health officials in Pennsylvania are aiming to process requests within three week. In years past, the longest an applicant waited for a birth certificate was four to six weeks.

Newborn birth certificates are usually mailed about three weeks after your child was born. The NYC Office of Vital Records is unable to provide information about your child's birth certificate before then. If you haven't received the certificate within four weeks, call 311 to ask for the status.

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PA H105.102
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