Missouri DHSS - Vital Records Applications and Forms · Missouri state form
Deputy Local Registrar Acceptance Form 580-0726
This form accepts an appointment as Deputy Local Registrar and includes an oath to support the constitutions and faithfully perform the office’s duties.
- What this form is
- Use this form to accept an appointment as Deputy Local Registrar of Vital Statistics for a specified registration district and county. The signer promises to support the United States and Missouri constitutions, discharge the position’s duties according to law, and observe Department of Health and Senior Services regulations. The form includes a notary section for the sworn statement and signature.
- Who needs it
- A person appointed as Deputy Local Registrar who must accept the appointment and swear to perform the office’s duties.
- Why it needs a notary
- The form includes an oath and a notary section, so the signature must be notarized. This can be done online with a commissioned online notary.
- How to submit it
- Submit it to the Missouri agency named on the form.
Questions
What is the Deputy Local Registrar Acceptance Form used for?
It is used to accept an appointment as Deputy Local Registrar of Vital Statistics for a specified registration district and county.
Does this form need to be notarized?
Yes. The form includes an oath and a “Subscribed and sworn to before me” section. The signature must be notarized, including online with a commissioned online notary.
What promises does the signer make?
The signer promises to support the United States and Missouri constitutions, faithfully perform the duties of Deputy Local Registrar, and observe the Department of Health and Senior Services regulations.