Online Certificate Specialists
What you will need to do is fill out the form below and hit the print button on your browser.Then make a copy of your driver’s license or your state issued identification card (if available) and fax both to us at 713-974-2221 or 713-974-6884. You MUST have a Discover, American Express, Visa or Mastercard number on the form below as this is how the states and ouir company will charge you for your Certificate The only states we can obtain Divorce Certificates are Alabama, Alaska, Arkansas, Colorado, Florida, Idaho, Kansas, Kentucky, Maine, Michigan, North Carolina, Oregon, South Carolina, Tennessee, Vermont, Virginia, Washington,West Virginia, Wisconsin and Wyoming.
PLEASE USE CAPITAL LETTERS ON THE FORM BELOW
.

Fees:    State Fee: $25.00-35.00    +    Our Fee: $45.00

Divorce Certificate Request
Husband's Name:
............................(First)(Middle)(Last)
Wife's Name:..... s
..............................(First)(Middle)(Last)
Date of Divorce:,County City
Reason for Request:State of Divorce:
Other:.. Number of Copies:
Relationship:,,,, .Other::.
Daytime Telephone #  () -  -
Ship Method:          ExpressCourier ...Number of Copies:
Ship to Name:
Ship to Address:***
City:State: Zip:
Email address:
Credit Card:Expires:
.................
Signature:______________________________________________ Date:
,,,,I authorize US Birth Certificate.Net to process this certificate.
,
All Sales Final
YOU MUST ALSO FAX A COPY OF YOUR DRIVERS LICENSE ( Call If unavailable)
***You must list a physical street address (No APO's , FPO's or PO Boxes) where someone can sign for the certificate
Please contact us if using a debit card for payments.
Please read the information on credit cards below..


Please contact us if the certificate does not arrive by the stated process time.



Please sign form in two places before faxing.
.


Is the credit card in your name?
If no... please also fax photo id of certificate holder & credit
card holder and have card holder sign authorization
below & certificate holder above.
If yes... please also sign the order form above & authorization
below & fax both pages with a photo ID.

Name of card holder: ______________________________

Signature of card holder: _____________________________________ Date:

I authorize USBirthcertificate. Net to charge my credit card for

the birth certificate request of ________________________
(Certificate holder name at birth)


Credit Card Billing Address if different from shipping address:


_________________________________________________

_________________________________________________

__________________________________________________


Please fax both pages of order form, and photo id of both the certificate holder
and the credit card holder (if different from certificate holder )




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Phone: 888-736-2692
Local: 713-974-1645
Fax: 713-974-2221  
Email: info
usbirthcertificate.net
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