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Birth or Death Certificate Application

Steps

  1. 1. Step One
  2. 2. Notarized Proof of Identification
  • Step One

    1. Fees

      Birth / Nacimiento $23 each
      Death / defunción $21 each $4 additional copies.
      Note: Valid photo identification required for Birth / Death certificates.
      Forms of payment accepted for mail requests only are cashier’s check or money order.
      Nota: Válido identificación con foto Se require para actas de Nacimiento / Defunción. Formas de pago acceptadas para solicitud de correo son cheque de caiero giro.

    2. 1. Full Name of Person on Record / Nombre del difunto / del que Nacio

    3. 2. Date of Birth or Death / Fecha de Nacimiento / defuncion

    4. 4. Place of Birth or Death / Lugar de Nacimineto / defuncion

    5. 5. Full Name of Father / Nombre del Padre

    6. 6. Full Maiden Name of Mother / Nombre de la Madre

    7. Contribute

      I wish to make a voluntary contribution of $ to promote healthy early childhood by supporting the Texas Home Visitation Program administered by the Office of Early Childhood Coordination of Health and Human Services.

    8. Warning

      It is a felony to falsify information on this document. The penalty for knowingly making a false statement on this form or signing a form which contains a false statement is 2 to 10 years imprisonment and a fine of up to $10,000. (Health and Safety Code, Chapter 195, Sec. 195.003).