El Dorado County, CA · El Dorado County
Affidavit of Homeless Status for Fee-Exempt Certified Copy of Birth Certificate
This affidavit documents homeless status when a person requests a fee-exempt certified birth certificate from the appropriate registrar or county recorder.
At a glance
- Issued by
- City of El Dorado County · El Dorado County, El Dorado County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- eldoradocounty.ca.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this affidavit when requesting a fee-exempt certified copy of a live birth record based on homeless status. The requestor identifies themselves or the homeless child or youth they represent, and an eligible homeless services provider verifies that status. Both the requestor and provider must sign and date the affidavit; other requirements for obtaining a certified birth record still apply.
Who needs it
A homeless person or eligible representative requesting a fee-exempt certified birth record needs this affidavit completed with verification from a homeless services provider.
How to submit it
The document says fee-exempt birth record requests may be made through the local registrar, the county recorder in the county where the registrant was born, or the State Registrar.
About notarization
No notary is required; the requestor and homeless services provider both sign and date the affidavit, which asks them to swear or affirm their statements.
How to submit this form
- 1
Download the Affidavit
Download the affidavit and read its information section before completing it.
- 2
Complete Section I
The requestor provides their name and identifies whether they are requesting for themselves or an eligible homeless child or youth.
- 3
Complete Section II
A homeless services provider enters its information and verifies the person’s homeless status.
- 4
Sign and Submit
The requestor and provider sign and date the affidavit. Submit the birth record request through an authorized registrar or county recorder.
Frequently asked questions
- Do I need a notary for the homeless status affidavit?
- No. The affidavit has signature and date lines for the requestor and homeless services provider, and asks them to swear or affirm their statements.
- Who completes the affidavit?
- The person requesting the birth record completes Section I. An eligible homeless services provider completes Section II to verify homeless status. Both must sign the affidavit.
- How do I submit the affidavit?
- The document says requests may go to the local registrar, the county recorder in the county where the registrant was born, or the State Registrar.