Applying for a birth certificate is an essential task for various legal and personal reasons. Located in Bedford, Texas, the city's Vital Statistics office facilitates this process, offering an application form that outlines the necessary steps for obtaining a certified copy of a birth certificate. With a fee of $23 for each certified copy, individuals can request one or more copies, with the option for expedited shipping available at an additional cost. Key information required includes the full name at birth, date of birth, sex, city of birth, along with the full names of the parents. Only certain relationships to the person whose certificate is being requested – such as self, sibling, parent, child, grandparent, legal representative, stepparent, guardian, spouse, or military recruiter – are recognized as qualified applicants. Moreover, the form stresses the importance of providing accurate information by warning of significant penalties for false statements, underscoring the document’s legal significance. Applicants are also reminded to attach a photocopy of their identification, without which the request cannot be processed. This careful collection of detailed, required information ensures that the process adheres to the administrative rules, maintaining the confidentiality and integrity of vital records which are restricted for 75 years.
| Question | Answer |
|---|---|
| Form Name | Birth Certificate Application Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | issuance, where do i get birth certificate near me, 00am, bedford birth certificate office |
CITY OF BEDFORD
VITAL STATISTICS
2000 FOREST RIDGE BEDFORD, TX
___ Abstract |
___ Full Record |
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BIRTH |
# REQUESTED
___1_ CERTIFIED COPY X $23.00 = $23.00
_____ EXTRA COPIES OF
SAME RECORD X $23.00 = ______
EXPEDITED SHIPPING = ______
Via Express Mail
TOTAL ENCLOSED = ______
State/Registrar File # ____________________
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Receipt No. |
________________ |
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APPLICATION FOR |
Cash |
________________ |
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CERTIFIED COPIES OF |
Check No. |
________________ |
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BIRTH CERTIFICATE |
Money Order ________________ |
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MC/Visa ____________________ |
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PLEASE PRINT |
Expiration __________________ |
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Control No. _________________ |
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THE FOLLOWING ARE THE ONLY |
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RECOGNIZED QUALIFIED APPLICANTS |
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Please check your relationship to person in #1:
____ Self |
____ Sibling |
____ Parent |
____ Child |
____ Grandparent |
____ Legal Representative |
____ Stepparent |
____ Guardian |
____ Spouse |
____ Military Recruiter |
I ACCEPT THIS CERTIFIED COPY AS IS:
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Full Name |
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First Name |
Middle Name |
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Last Name at Birth |
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On Birth Record |
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Date Of Birth |
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Month |
Date |
Year |
3. Sex |
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City Of Birth |
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City or Town |
County |
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State |
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TEXAS |
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Full Name Of Father |
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5. |
First Name |
Middle Name |
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Last Name |
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Full Maiden Name |
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6. |
First Name |
Middle Name |
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Maiden Name |
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Of Mother |
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8. YOUR NAME: _________________________________________ |
9. Phone# 8:00am – 5:00pm (_____)_________________ |
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10. MAILING ADDRESS: ________________________________________________________________________________ |
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STREET ADDRESS |
CITY |
STATE |
ZIP |
11.YOUR RELATIONSHIP TO PERSON IN ITEM 1: __________________________________________________________
12.PURPOSE FOR OBTAINING THIS RECORD: ____________________________________________________________
WARNING: THE PENALTY FOR KNOWINGLY MAKING A FALSE STATEMENT IN THIS FORM CAN BE
____________________________________ |
____________________________ |
SIGNATURE OF APPLICANT |
DATE |
IDENTIFICATION TYPE ________________________ |
NUMBER _________________________ |
Driver’s License, I.D. Card, etc. |
on Driver’s License, I.D. Card, etc. |
Birth records are confidential for 75 years: therefore, issuance is restricted to qualified applicants. PLEASE ATTACH A PHOTOCOPY OF IDENTIFICATION TO APPLICATION. WE WILL PROCESS NO REQUEST WITHOUT IDENTIFICATION. Administrative rules require that on restricted records, all identifying information (items
Fees are subject to change without notice. (Call
Office Use Only |
Issued by: |