How to Request Verification of a Birth or Death Record
This form is used by a government agency requesting certification of a vital records for official business purposes, such as employment or security purposes or to close a case file. The government agency must provide sufficient information for Vital Records program staff to locate a record. Vital Records program staff indicate if a record exists and if the data identified by the government agency is certified per the record.
Download, print, and fill out a Request for Certification of a Birth Record or Request for Certification of a Death Record. Mail your request to the Department of Health's Division of Vital Records at:
Department of Health
Bureau of Health Statistics & Registries
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103