Tax season is now in full swing and for many individuals, that means preparing and filing Form Ph 3061 - Pennsylvania Personal Income Tax Return. This form is used to report taxable income, calculate tax liability, and claim credits and deductions. If you need assistance preparing your return, the Pennsylvania Department of Revenue offers a number of resources including instructional videos, webinars, and frequently asked questions. Be sure to review all of the information available before filing to ensure that your return is accurate and complete.
Question | Answer |
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Form Name | Form Ph 3061 |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | verification of birth facts, mailing, TENNESSEE, 5th |
TENNESSEE DEPARTMENT OF HEALTH
OFFICE OF VITAL RECORDS
APPLICATION FOR VERIFICATION OF BIRTH FACTS
THIS APPLICATION MUST BE ACCOMPANIED BY A CHECK OR MONEY ORDER MADE
PAYABLE TO TENNESSEE VITAL RECORDS FOR $12.00.
Name and mailing address where verification is to be sent:
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Name of Individual or Requesting Agency |
Date |
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Street Address |
Telephone No. |
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City |
State |
Zip |
In order for the Office of Vital Records’ staff to search the files of birth records, please provide the following information from the record you are requesting:
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Year of Birth
_____________________ |
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__________________________ |
___________________________ |
Name of Child at Birth |
or |
Name of Father (if named) |
or Name of Mother (if no father named) |
Also complete items
A fee of $12.00 is charged for the search of the year and the name entered above. This fee is charged even if no record is found. If you want to search more than one year of records, please enclose $12.00 for each additional year.
1. |
Full name at Birth: _____________________________________________________________ |
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First |
Middle |
Last |
2. |
Date of Birth: _______________________________________ |
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Month |
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Day |
Year |
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3. |
Gender: (Circle One) |
Male |
Female |
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4.City or County of Birth: __________________________________________________________
5.Mother’s Full Maiden Name: ______________________________________________________
FirstMiddleLast
6. Father’s Full Name: _____________________________________________________________
First |
Middle |
Last |
MAIL THIS APPLICATION TO: |
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Tennessee Department of Health |
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OFFICE OF VITAL RECORDS |
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Central Services Building |
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421 5th Avenue North, 1st floor |
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Nashville, TN 37247 |
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Version 10/02 |
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RDA N/A |
Do not write below. The staff at the Office of Vital Records will enter information.
This form is not a birth certificate. The information is transcribed from the original document.
This cannot be used as a form of identification.
1.Child’s Full Name at Birth:
2.Date of Birth:
3.Sex:
4.Time of Birth:
5.Place of Birth:
6.Facility or Hospital:
7.Mother’s Full Maiden Name:
8.Mother's Age or Date of Birth:
9.Mother’s State of Birth:
10.Mother’s Occupation:
11.Father's Full Name:
12.Father’s Age or Date of Birth:
13.Father’s State of Birth:
14.Father’s Occupation:
15.Mailing Address at Birth:
16.Attendant at Birth:
17.Attendant’s Address:
18.Date Certificate Filed:
Other Information:
We were unable to locate a certificate with information given.
Verified By:
Title:
Date Verified:
Version 10/02 |
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RDA N/A |