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  • Pa H105.102 2020

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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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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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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
PA H105.102
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