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1. Personal Information: Full name, date of birth, place of birth, sex, and race of the person whose birth is being registered
2. Parents' Information: Names, ages, places of birth, and occupations of both parents at time of birth
3. Declarant Information: Details of person filing the delayed birth certificate, including relationship to registrant
4. Reason for Delay: Explanation of why the birth was not registered at time of occurrence
5. Supporting Evidence: List of documentary evidence being submitted to support the delayed registration
1. Medical Information: Details about the birth if medical records are available, used when birth occurred in medical facility
2. Witness Statements: Additional testimonies from witnesses, used when documentary evidence is limited
3. Tribal Information: Required for Native American registrants when applicable
1. Documentary Evidence: Copies of supporting documents (school records, church records, census records, etc.)
2. Affidavit Forms: Sworn statements from witnesses or persons with knowledge of birth
3. Identity Verification Documents: Copies of declarant's identification documents
4. Fee Schedule: List of applicable fees and payment methods
Registrant
Declarant
State Registrar
Local Registrar
Documentary Evidence
Supporting Affidavit
Place of Birth
Date of Birth
Legal Guardian
Facts of Birth
Vital Records
Birth Certificate
Primary Evidence
Secondary Evidence
Attending Physician
Midwife
Birth Attendant
Certifying Official
Jurisdiction of Birth
State of Birth
County of Birth
Legal Representative
Notary Public
Vital Statistics Office
Acceptable Evidence
Filing Date
Registration Date
State of Record
Proof of Identity
Personal Information
Parental Information
Place of Birth
Supporting Evidence
Verification
Attestation
Notarization
Penalties for False Statements
Documentary Requirements
Privacy Protection
Information Release Authorization
Certification
Witness Statements
Fee Payment
Processing Time
Amendment Rights
Appeal Rights
Record Access
Identity Verification
Supporting Documentation
Legal Authority
State Jurisdiction
Information Accuracy
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