Vital Records Birth/Death Application
A photocopy of a current government, school or employer photo identification of the
applicant must be submitted with all requests.
Applications without proper identification will be returned unprocessed.
Name of applicant:_____________________________________________________________ Day phone number:______________________
Address: _____________________________________________________________________________________________________________
City:______________________________________________ State:_______________________________ Zip code:_______________________
Note: Mail from Vital Records will not be forwarded by the USPS.
Address certificate to be mailed to if different than applicant’s address:
Name: _______________________________________________________________________________________________________________
Address: _____________________________________________________________________________________________________________
City: ___________________________________________________________ State: _________________________ Zip code: ______________
Your relationship to person named on the certificate. (Check one - will be used to determine entitlement)
____Self |
____ Adult child |
____ Family member (specify) ____________________________________________________ |
____Parent |
____ Legal Guardian |
____ Legal representative (for whom?)______________________________________________ |
For what purpose are you requesting this certificate? _______________________________________________________________________
By signing this application, I understand that making a false application for a vital record is a felony under state law.
Signature of applicant: __________________________________________________________________________________________________
BIRTH CERTIFICATES
Full name: ____________________________________________________________________________________________________________
FirstMiddleLastSuffix
Date of birth:_____________________Sex: ________City of birth:___________________________ County of birth: ________________________
Name of mother prior to any marriage:_______________________________________________________________________________________
FirstMiddleLast
Name of father:_________________________________________________________________________________________________________
FirstMiddleLast
Mother's state of birth: ________________________________________ Father's state of birth:________________________________________
Were parents married at time of birth: ___ Yes ___ NoNumber of children born in SC to this mother?____________
Name at birth if ever changed for any reason other than marriage: ________________________________________________________________
Specify the number and type of certification(s) requested: (Long form recommended)
____ Birth long ($12) ____ Additional long ($3 each) |
____ Birth short ($12) ____ Additional short ($3 each) |
Total fees submitted:__________________ |
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DEATH CERTIFICATES |
Name of deceased: _____________________________________________________________________________________________________
FirstMiddleLastSuffix
Date of death: _____________________ Sex:_______ Age at death:_______ City/County of death:__________________________________
Specify the number and type of certification(s) requested: |
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____ Death long ($12) ____ Additional long ($3 each) |
____ Death short ($12) ____ Additional short ($3 each) |
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____ Death statement ($12) ____ Additional statement ($3 each) |
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Total fees submitted:_____________________________________ |
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Send completed application/photocopy of identification to: |
SC DHEC – Vital Records |
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2600 Bull Street, Columbia, SC 29201 |
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OFFICE USE ONLY |
SFN: |
DCN: |
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SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
See back for Instructions and Information
Vital Records Application for Birth and Death Certificates
Instructions and Information
1)One form may be used to request a certified copy of a birth certificate only, or a certified copy of a death certificate only, or a certified copy of a birth and death certificate if for the same individual.
2)Complete all of the information in the top section of the form and all information
in the birth and/or death sections based upon whether a birth, death or both certificate(s) are being requested.
Information
BIRTHS AND DEATHS – SC Law did not require the filing of birth and death records until January 01, 1915. No birth or death records on file at
SCDHEC (county or state) are available for public viewing.
A death record becomes public record fifty (50) years after the date of death. Non-certified copies of public death records are issued unless a certified copy is specifically requested. The $12 "search fee" is required for each request of a public death record.
Death records are avaliable for public viewing fifty (50) years after the date of death ONLY at the SC Department of Archives and History, 8301 Parklane Road, Columbia, 29223, website: http://archives.sc.gov.
TURNAROUND TIME – The usual turn around time for ‘waiting’ on-site customers is approximately thirty (30) minutes during non-peak hours (8:30 am - 11:00 am and 2:00 pm - 4:00 pm). The usual turn around time for "mail" requests is approximately 7 - 10 business days from the date of
receipt.
If it has been more than four (4) weeks since you submitted your request, call (803) 898 3630 to determine the status.
IDENTIFICATION – A valid/current government, school or employer issued photo identification document of the applicant is required before a search of the records will be conducted. Requests that do not contain proper identification will be returned unprocessed. Acceptable documents
are:
1.Any United States’ DMV Office issued picture identification i.e. Driver’s License, ID card, Learner’s Permit (unexpired)
2.Current school or employer picture identification card
3.Military card (unexpired – active duty or retired member)
4.United States Passport (unexpired)
5 Foreign Passport (with unexpired)
6.Re-Entry Permit (l-327 – unexpired)
7.Refuge Travel Document (form l-571 – unexpired)
8.United States Citizen Identification Card (form l-197)
9.Temporary Resident Card (form l-688 – unexpired)
10.Permanent Resident Card (form l-551 – unexpired)
11.Weapon or gun permit issued by federal, state or municipal government (unexpired)
Website – www.scdhec.gov/vr/ provides additional information on SC Vital Records.
PAYMENT – Acceptable methods of payment for mail requests are a money order or cashier’s check made payable to SC DHEC. Onsite customer
service also accepts credit and debit cards and cash.
SEARCH FEE – A $12 “search fee” is required by law. The $12 search fee is non-refundable. The required search fee includes one (1) certifica- tion, if record is located. If additional copies of the same type certification are ordered at the same time, additional copies are $3 each.
TYPE OF CERTIFICATIONS |
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Birth Long contains parentage (recommended) |
Death Long includes cause of death |
Birth Short/Wallet does not include parentage (not acceptable for most purposes) |
Death Short does not include cause of death |
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Death Statement only includes fact of death |
DHEC-0640 (09/2013) |
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