Missouri DHSS - Vital Records Applications and Forms · Missouri state form
580-3231 Application for Non-Certified Copy of Original Birth Certificate by Lineal Descendant
Use this application to request a non-certified copy of an adopted person’s original birth certificate as a lineal descendant. A notary must witness your sworn declaration.
- What this form is
- This application is for a lineal descendant seeking a non-certified copy of an adopted person’s original birth certificate and accompanying forms, if completed. Applicants must provide proof of the adopted person’s death and proof of lineal descent. The application includes a sworn declaration and a notary section. A non-refundable $15 search fee must accompany the application; payment may be made by check or money order.
- Who needs it
- A lineal descendant of a deceased adopted person who seeks a non-certified copy of that person’s original birth certificate.
- Why it needs a notary
- The application includes a declaration that must be subscribed and sworn before a notary. This can be done online with a commissioned online notary.
- How to submit it
- Mail the application with payment to the Bureau of Vital Records, P.O. Box 570, Jefferson City, MO 65102-0570, or submit it at the Bureau’s office in Jefferson City.
Questions
Who may request a non-certified original birth certificate with this application?
A lineal descendant of an adopted person who is deceased may apply. The application requires proof of the adopted person’s death and proof of lineal descent.
How do I submit form 580-3231?
Mail the completed application and payment to the Bureau of Vital Records, P.O. Box 570, Jefferson City, MO 65102-0570, or submit it in the Bureau’s office in Jefferson City. The form says the search fee is non-refundable.
Does this application need to be notarized?
Yes. The application includes a declaration to be subscribed and sworn before a notary, with spaces for the notary’s signature and commission information. This can be done online with a commissioned online notary.