Form Hhs 88 PDF Details

At the heart of ensuring the accuracy and integrity of personal records in Nebraska lies the DHHS Application for Certified Copy of Birth Certificate, a pivotal form managed by the Nebraska Department of Health and Human Services (DHHS). Since 1904, the Nebraska DHHS has been dedicated to registering births within the state, providing individuals a formal way to obtain official documentation of their birth. Designed for clarity and ease of use, instructions on the form stipulate that all information should be typed or printed legibly to avoid errors. Among the details requested are the full name at birth, including adoptive names if applicable, the exact date and place of birth, and full names of both parents or adoptive parents. This form serves not only those seeking documentation of their own birth but also individuals applying for records on behalf of someone else, for which it asks the applicant to specify their relationship to the person named on the record. Additionally, in certain circumstances where a standard birth certificate was not filed at the time of birth or for those born before 1904, the form provides an option to apply for a delayed birth certificate. An important note highlighted is the legal warning against the misuse of such vital records, indicating that fraudulent use is a felony offense. The process also requires proof of identification and a fee per copy requested, underscoring the importance of both security and accessibility in obtaining these vital records. With its comprehensive approach, the DHHS 88 form stands as a crucial element in upholding the legal and procedural standards for acquiring certified birth certificates in Nebraska.

QuestionAnswer
Form NameForm Hhs 88
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnebraska birth certificate, pdf blank birth certificate, nebraska birth certificate application, birth certificate from nebraska

Form Preview Example

DHHS

APPLICATION FOR CERTIFIED COPY OF BIRTH CERTIFICATE

Nebraska Department of Health

and Human Services

This office has been registering births for persons born in Nebraska since 1904.

PLEASE TYPE OR PRINT LEGIBLY

Full name at birth_____________________________________________________________________________________

(If adopted, list adoptive name)

Month, day, and year of birth ___________________________________________________________________________

City or town of birth _____________________________County of birth __________________________________________

Father’s full name ____________________________________________________________________________________

(If adopted, list adoptive father’s name)

Mother’s full maiden name______________________________________________________________________________

(If adopted, list adoptive mother’s name)

Is this the record of an adopted person? q Yes q No

For what purpose is this record to be used? ________________________________________________________________

If this is not your record, how are you related to the person named on the record? __________________________________

Delayed Birth Certificate - Legislation passed in 1941 provides for the filing of delayed birth certificates for persons who were born prior to 1904 OR for persons whose births were not recorded at the time of birth.

Is this a delayed birth certificate? q Yes

q No

WARNING: Section 71-649, Nebraska Revised Statutes: It is a felony to obtain, possess, use, sell, furnish, or attempt to obtain any vital record for purposes of deception.

SIGNATURE OF REQUESTOR ______________________________

Type or print name_________________________________________

Street Address____________________________________________

City, State, Zip ___________________________________________

Telephone Number: _______________________________________

Today’s Date _____________________________________________

(Please enclose a photocopy of your photo ID [i.e. current driver’s license] when mailing in this request).

Fees are subject to change without notice. Please call our 24-hour recorded message at (402) 471-2871 to verify fees.

Number of certified copies________ x $12.00 each = $________ Total

(Please make checks payable to Vital Records)

Mail to:

Bring to:

Vital Records

Vital Records

PO Box 95065

1033 O Street, Suite 130

Lincoln, NE 68509-5065

Lincoln, NE 68508-3621

(Please enclose a stamped,

 

self-addressed business

 

size envelope.)

 

FOR OFFICE USE ONLY

 

q Check q MO

q Cash

Amount Received ________________________

Date Received __________________________

By Whom Received ______________________

PROOF OF IDENTIFICATION;

DLSTATE IDOTHER

______________________________________

HHS-88 (55088) 7/09

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