Get Missouri Department Of Health And Sen

Filling out the Missouri Department of Health and Senior Services' application for a vital record can be straightforward if you follow the right steps. This guide provides clear instructions to help users complete the form accurately, ensuring that all necessary information is provided for a successful request.

Follow the steps to complete the application for a vital record

1. Click 'Get Form' button to obtain the form and open it for editing.
2. Provide the number of copies requested for the birth record. The first copy costs $15, and each additional copy also costs $15. Fill in the full name as it appears on the certificate.
3. Indicate if the person also has another name by writing it under 'Also known as.' Next, include the date and place of birth (city, county, state) in the designated fields.
4. Enter the hospital name and the full name of the father in their respective sections. Specify the sex of the individual by selecting either 'Female' or 'Male' and provide their race.
5. For the mother, fill in the full maiden name. If requesting a death record, provide the same necessary details including the number of copies. The costs vary: the first copy is $13 and subsequent copies of the same record are $10.
6. Complete the full name on the death certificate, as well as the date and place of death. Also, specify the sex, race, and full names of the spouse, father, and mother.
7. Fill in your information, including your name, phone number, street address, city/town, state, and zip code in the designated applicant fields.
8. State the purpose for the certificate request and your relationship to the person named on the record. If applicable, include documentation for guardianship or legal representation.
9. Sign the application, declaring that the information provided is true under penalty of perjury. Include the date of your signature.
10. Ensure that your request is notarized, as all mail-in requests must be. Finally, include a self-addressed stamped envelope with your application for response.
11. Once everything is filled out and signed, save your changes before downloading, printing, or sharing the form as needed.

Begin your application for a vital record online today.