California Department of Public Health - Vital Records · California state form
VS 111 SP Application for Certified Copy of Birth Record
Use VS 111 SP to request an authorized or informational certified copy of a California birth record from the California Department of Public Health, Vital Records.
- What this form is
- VS 111 SP is an application for an authorized or informational certified copy of a birth record. Applicants provide information about the person named on the certificate, their relationship to that person, and their own contact details. The instructions explain eligibility, required supporting documents, payment, and submission. An authorized copy requires a notarized sworn statement unless an exemption listed on the form applies; an informational copy does not.
- Who needs it
- People requesting an authorized or informational certified copy of a California birth record from CDPH Vital Records should complete this application.
- Why it needs a notary
- An authorized-copy request requires a notarized sworn statement, which can be notarized online with a commissioned online notary; informational-copy requests do not require one.
- How to submit it
- Complete the application, include the required check or money order and any applicable notarized sworn statement, and mail it to CDPH Vital Records at the address printed on the form.
Questions
Who can request an authorized copy of a birth record?
The form lists eligible people, including the registrant and specified family members, as well as certain attorneys, agencies, and people authorized by court order or law. Applicants must identify their relationship to the registrant.
Is a notary needed for the VS 111 SP application?
A notarized sworn statement is required for an authorized-copy request, unless an exemption listed in the instructions applies. You can complete the notarization online with a commissioned online notary. Informational-copy requests do not require a sworn statement.
How do I submit the birth record copy application?
Complete the application and mail it with the required check or money order and any applicable sworn statement to the CDPH Vital Records address printed on the form. The form says not to send cash.