AR Birth Certificate Form – How to Fill Out and Submit

Ar Birth Certificate Form PDF Details

The Arkansas birth certificate application form is the official request document used by the Arkansas Department of Health Vital Records office to process certified copies of birth records for births occurring within the state.

Who Needs This Form

This form is required by anyone requesting a certified copy of an Arkansas birth record for legal, personal, or genealogical purposes. The Arkansas Vital Records office maintains records for births occurring within Arkansas dating back to February 1, 1914. Applicants must provide potential names and birth dates under which the certificate may be registered to help the office locate the correct record.

Required Documents

• Completed AR birth certificate application form with your signature
• Copy of a valid government-issued photo ID
• Payment of the applicable fee by check, money order, or credit card depending on how you submit

Fee Structure

The Arkansas Department of Health Vital Records charges a non-refundable search fee for each request:

• First certified copy: $12.00
• Each additional copy of the same record: $10.00

The search fee is non-refundable even if no record is found. Applicants should provide all potential name variations and birth date ranges when submitting the form to improve search accuracy.

Submission Options

Applicants may submit their completed birth certificate request by several methods:

• Online: Expedited service is available through authorized ordering services on the internet
• Phone: Toll-free ordering is available for credit card payments
• Walk-in: Visit the Arkansas Department of Health office in Little Rock during business hours
• Mail: Send the completed form with payment and a copy of your photo ID to the Vital Records office