BirthCertificate - Vital Records

Please note for recent/new Births: Please allow 21 days from the date of the birth for certificates to be available for purchase.

* Required field

Birth Record Information

First Name of Child

Middle Name of Child

Last Name of Child

Date of Birth

Hospital Birth?

Place of Birth

Hospital of Birth

City of Birth

Number of Copies

Birth/Legal Parent Information

Birth Parent

Parent First Name

Parent (Birth) Last Name

Parent Phone Number

Parent Email Address

Other Parent

Parent First Name

Parent Last Name

Parent Phone Number

Parent Email Address

Type of certified copy you are requesting

	Certified Authorized Copy.
Only specific people are eligible to receive this record. This document will establish the identity of the registrant. Refer to Relationship to Registrant section to see if you are eligible. If not, you must request a Certified Informational Copy.

	Certified Informational Copy.
Everyone is eligible to request this record. This document will be printed with a legend on the face of the document that states: "INFORMATIONAL, NOT A VALID DOCUMENT TO ESTABLISH IDENTITY."

Relationship to Registrant

Check the box that establishes your relationship to the person listed on the certificate.

I am:

	A parent or legal guardian of the registrant (person listed on the certificate).
	A child, grandparent, grandchild, brother or sister, spouse, or registered domestic partner of the registrant.
	A party entitled to receive the record as a result of a court order, or an attorney or a licensed adoption agency seeking the birth record in order to comply with the requirements of Section 3140 or 7603 of the Family Code.
	A member of a law enforcement agency or other government agency, as provided by law, who is conducting official business.
	An attorney representing the registrant or the registrant's estate, or any person or agency empowered by statute or appointed by a court to act on behalf on the registrant's estate
	Appointed rights in a power of attorney. The principal (person authorizing the other to act) must be qualified to receive a certified copy.
	An executor of the registrant's estate.
	None of the above.

Document

Sworn Statement

By entering my full name in the space provided below I swear or affirm under penalty of perjury under the laws of the State of California, that I am an authorized person, as defined by the California Health and Safety Code Section 103526 (c), and am eligible to receive an authorized copy of this birth certificate.

First Name

Middle Name (optional)

Last Name

The County of Riverside is not responsible for the delivery of mail by the United States Post Office or any other delivery service.