Form 45 13A PDF Details

Ordering a vital record, such as a birth certificate, through mail involves a detailed process encapsulated within the Oregon Birth Record Order Form, known officially as the 45 13A form. This essential document, provided by the Oregon Center for Health Statistics, serves as a gateway for individuals to obtain certified copies of birth records by adhering to specific requirements. The form mandates the inclusion of crucial details ranging from the full name and date of birth on record to the requester's relationship to the person named on the form and the reason for needing the record. Furthermore, it outlines the costs associated with securing the first record and any additional copies, emphasizing the non-refundable nature of these fees once a search has been initiated. To ensure the request is processed without delay, the form also requires a photocopy of a valid ID from the person ordering the record, or, in its absence, alternative forms of identification. With a spectrum of eligible requesters defined by law and varied options for submission, including mail, in-person, and online through third-party vendors, the 45 13A form embodies a critical process in maintaining accurate and accessible health statistics while also safeguarding personal information under strict legal statutes.

QuestionAnswer
Form NameForm 45 13A
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other nameschs, NRL, NSF, E-mail

Form Preview Example

ARE YOU ORDERING A VITAL RECORD BY MAIL?

YOU MUST:

Sign the form

Include a photocopy of your ID

See form for details.

Thank you!

Oregon Vital Records

Oregon Birth Record

ORDER FORM

CENTER FOR HEALTH STATISTICS

1.Full name on record:

2.Date of birth:

Number of certified records requested. QUANTITY $20 first record/$15 each additional copy

of the same record ordered at the same time.

(First)

 

(Full middle)

(Full last)

3. Sex:

 

4. Place of birth:

 

OREGON

(MM/DD/YYYY)

(M or F)

(City)

(County)

5. Mother’s full maiden name:

(First)(Full middle)(Full maiden)

6. Father’s full name:

(First)

(Full middle)

(Full last)

7.Your relationship to person named in line 1:

8.Reason for needing record:

9. Daytime telephone number:

 

10. Email:

11.Name of person ordering:

12.Your address:

13.City/State/ZIP:

14.Required: Signature of person ordering:

15.ID Required: Person ordering must attach legible photocopy of current, valid ID or legal representative document. See back of form for alternative ID options.

Send to:

Make checks/money orders payable to:

OREGON VITAL RECORDS

OHA/Vital Records

PO BOX 14050

PLEASE DO NOT SEND CASH

PORTLAND OR 97293-0050

Checks/money orders in U. S. Dollars

 

 

In accordance with law – ORS 432.121, only the person named on the record, immediate family members, legal representatives, government agencies and persons licensed or registered under ORS 703.430 are eligible to access birth records. For all others, access to birth records is restricted for 100 years. Legal guardians must enclose a copy of the legal document. If you are not eligible, enclose a written permission note with a notarized signature of an eligible person.

OFFICE USE ONLY

DO NOT WRITE IN THIS SPACE

Certificate number:

 

 

1

 

2

 

Film

 

 

 

 

 

Film (P)

 

 

 

 

 

Computer

 

 

 

 

 

Indexes

 

 

 

 

 

Index (P)

 

 

 

 

 

DF/CO

 

 

 

 

 

Refund: $

 

 

 

 

 

 

 

 

 

 

 

Excess fee

Out/state

 

 

No record

Uncompleted

 

 

Check #:

 

 

 

 

 

 

 

 

 

 

 

File date:

Amendment fee:

 

 

 

 

 

 

 

 

NRL/ref. issued:

Full issued:

 

 

 

 

 

 

 

 

Follow-up:

Computer copy:

 

 

 

 

 

 

 

 

Providing false information is a felony under ORS 432.900.

$20.00 FOR THE FIRST RECORD; $15.00 FOR EACH ADDITIONAL COPY OF THE SAME RECORD ORDERED AT THE SAME TIME. The $20.00 fee is non-refundable once the search for the record has been completed. Administrative Rule 333-011-0106 (2)

This form available in alternative formats. See back for details.

ENTER YOUR MAILING ADDRESS

THIS SECTION WILL BE DETACHED AND USED AS A MAILING LABEL

Name

Street

City

State

ZIP

Non-Sufficient Funds (NSF) check processing policy: In the event that your check is returned unpaid for insufficient or uncollected funds, we may present your check electronically. In the ordinary course of business, your check will not be provided to you with your bank statement, but a copy can be retrieved by other means. A $25.00 penalty may be assessed for NSF checks per ORS 30.701(5).

See back of form for ordering options and processing times. Information is also available on our Web page at: www.healthoregon.org/chs or by calling 971-673-1190.

45-13A (01/12)

This form can be provided upon request in alternative formats for individuals with disabilities. Other formats may include (BUT ARE NOT LIMITED TO) large print, Braille, audio recordings, Web-based communications, and other electronic formats.

Call 971-673-1180 (voice) or 971-673-0372 (TTY), or FAX 971-673-1203 to arrange for the alternative format that will work best for you.

Alternative identification you can send with your mail order.

If you don’t have a valid driver’s license, ID card, or passport, send photocopies of three (3) different documents that include both your name and current address. Suggested documents are listed below. If you are mailing your order, make photocopies of the documents and include them with your order form.

Documents must be dated within the last thirty days and show current mailing address where record will be mailed.

Utility bill (such as telephone, gas, electric, water, garbage removal) or other bill;

Insurance statement, medical statement, or paycheck stub;

Court document or parole document;

Work ID, unemployment statement, food stamp, or other benefit card (copy both sides);

Valid permit for firearms, fishing, hunting, or other license;

Vehicle registration, title, or insurance statement.

If you have no ID or other documents, an immediate family member can order for you and send in their ID. Your mother or father, your mother’s parents or your father’s parents (if your father is listed on your birth record), or your adult children are immediate family members who may order. Records can also be released to a legal representative of an immediate family member or to a government agency.

How long does it take to receive a record requested by mail? Processing time varies between five and seven weeks depending on seasonal workload. To assure fast processing for mail orders, use a money order instead of a personal check. Payment by personal check may delay processing by three weeks if the check is on a new account, is a temporary check, does not include a printed name or address, or has a change to the printed name or address. If an amendment is being processed, the record is not on file, or ID or information is missing or in error, expect an additional delay of two to four weeks.

Order in person and receive the record in 30-40 minutes at self service kiosks. Cost: $23.25 for one record and security fee. Fees are not refundable after orders are submitted.

State Vital Records Office: 800 NE Oregon Street, Suite 205 Portland OR 97232-2162

Office Hours: 8:00 a.m. to 4:30 p.m., Monday through Friday. Orders must be submitted by 4:00 p.m. to receive a record the same day.

Ordering in person is limited to immediate family members of the person named on the record and their legal representatives. The identity of the applicant will be screened using SSN and date of birth. The cost of each screening is $3.25. Persons ordering must show valid ID or provide alternative identifying documents. In some cases, proof of relationship may be required if the person ordering does not share the last name of the person on the record and is not clearly an immediate family member. Payment by credit or debit card, cash, money order, or electronic fund transfer (EFT) of a personal check accepted.

Order online: www.vitalchek.com at any time. Cost: $36.50 for one record shipped by regular mail.

Order by telephone through VitalChek: 1-888-896-4988, 24 hours a day 7 days a week except for major

holidays. Cost: $38.45 for one record shipped by regular mail. Fees are not refundable. All major credit/debit cards accepted. Orders are processed through the VitalChek Network. The fee includes an additional $18.45 to cover vendor, security, and expedite fees per order. Overnight shipping is available for an additional fee that varies depending on vendor and place of delivery. Records will be mailed/shipped within two work days of receipt unless a record problem is discovered. Shipments can be delayed for missing or incorrect information, or if records are still being registered or amended.

How to Edit Form 45 13A Online for Free

By using the online editor for PDFs by FormsPal, it is easy to complete or edit oregon birth certificate application pdf here. Our team is devoted to providing you the best possible experience with our tool by regularly releasing new capabilities and upgrades. With all of these improvements, working with our editor gets easier than ever! To get the ball rolling, go through these easy steps:

Step 1: Firstly, open the pdf tool by clicking the "Get Form Button" in the top section of this site.

Step 2: When you launch the online editor, you will get the form prepared to be filled out. Other than filling out different blanks, it's also possible to do various other actions with the file, such as adding custom words, editing the original text, adding images, putting your signature on the form, and more.

This document will require particular info to be typed in, hence you need to take the time to provide what is asked:

1. Fill out your oregon birth certificate application pdf with a group of necessary blank fields. Consider all of the required information and make certain there's nothing neglected!

Part no. 1 in completing 45-13A

2. Once this array of fields is completed, you have to put in the needed particulars in Name, Street, City, State, ZIP, NonSuffi cient Funds NSF check, and See back of form for ordering allowing you to proceed further.

Filling in segment 2 in 45-13A

People generally make mistakes when filling out NonSuffi cient Funds NSF check in this area. Be certain to revise whatever you enter here.

3. Completing Ordering in person is limited to is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

45-13A conclusion process described (step 3)

Step 3: Prior to addressing the next step, ensure that all blank fields have been filled in right. The moment you think it is all good, press “Done." Acquire your oregon birth certificate application pdf once you join for a 7-day free trial. Immediately view the form in your personal account page, along with any modifications and changes all kept! FormsPal provides protected form tools without data recording or any type of sharing. Feel safe knowing that your data is secure with us!