Birth Certificate Request for


To: Whom It May Concern:

Please forward to my attention a certified birth certificate for:

Exact Name:
Date of Birth:
Town or City of Birth:

I am the individual for whose record is being requested.

Enclosed is my credit card information for your use to pay for my request:

Credit Card Number:
Expiration Date:
Exact Name on Card:

If you require a check instead, please send me the amount due in the enclosed stamped self-addressed envelope and I will send it to you by return mail.

Thank you for your assistance in this matter,

Best regards,


Birth Certificate, Request for
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. If you are a Trustee or Executor making this request, simply rewrite the language to reflect that fact and include a copy of your official authorization to act in that capacity. Keep a copy of the transaction so you can send in a second notice. We recommend you make a phone call, if possible, to the proper location first to find out whether you need to have a bank check instead of a credit card, the correct amount of the total charge, and the proper department to send it to. On the other hand, if you have time and are not in a hurry, it can be less frustrating and just as effective in the long term, to send out an initial letter and let the bureaucracy grind slowly and respond at its pace.




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