Get Ne Hhs-89 2021-2026

The NE HHS-89 form, also known as the Application for Certificate of Birth Resulting in Stillbirth, is designed for parents seeking a certified birth certificate for their stillborn child. This guide will provide clear, step-by-step instructions to ensure a smooth completion of the form.

Follow the steps to complete the NE HHS-89 form online.

1. Press the ‘Get Form’ button to obtain the NE HHS-89 form and open it in your browser or document editor.
2. Begin by entering the full name of the child in the designated field, ensuring accuracy and clarity.
3. Next, input the month, day, and year of the stillbirth in the appropriate section.
4. Indicate the city or town where the stillbirth occurred, followed by the county in the specified fields.
5. Fill in the full name of the father or parent, followed by the mother or parent's name as recorded at birth.
6. State the purpose for which the birth record will be used in the corresponding section.
7. Clarify your relationship to the individual listed on the record in the designated area.
8. Sign the form in the signature field, ensuring that it is your name as the requestor.
9. Provide your street address, city, state, and zip code in the fields designated for your contact information.
10. Enter your telephone number and email address to allow for easy communication regarding the request.
11. Include today's date in the date field at the bottom of the form.
12. If mailing the completed request, make sure to enclose a photocopy of your photo identification, as outlined in the instructions.
13. For office use only: Acknowledge that the payment methods such as checks or cash are to be filled out appropriately in the office section.
14. Once all fields are completed, save the changes, and you will have the option to download, print, or share the completed form.

Complete your NE HHS-89 form online today to request your certified Certificate of Birth Resulting in Stillbirth.