VS 111 PDF Details

Birth records are available 21 days after the date of event.

Where to request: you may request a copy from either the county of birth or from the California Department of Public Health Vital Records (CDPH-VR).

Counties: counties can only issue records for events that occurred in that county.

Authorized copy: only authorized individuals (Health and Safety Code Section 103526) listed in Part 1 may obtain an authorized copy.

Notary: sworn statements must be notarized for authorized copy requests.

Agencies: law enforcement and governmental agencies are exempt from the notary requirement, but must complete the top portion of the sworn statement page.

Separate applications: complete a separate application for each birth record requested.

QuestionAnswer
Form NameVS 111
Form Length8 pages
Fillable?Yes
Fillable fields50
Avg. time to fill out9 min
EditionRev 01/2026
Issuing agencyCalifornia Department of Public Health
Where to sendCalifornia Department of Public Health Vital Records - MS 5103, P.O. Box 997410, Sacramento, CA 95899-7410
Other namesVS 111, VS111, Form VS 111, Application for Certified Copy of Birth Record, California birth certificate application
Official sourceVS 111 (Rev 01/2026), California Department of Public Health