U.S Birth Certificate . Net

You cannot order over the phone so please follow the steps below
Step1. You must type & print out order form below (USE CAPITAL LETTERS )
Step2. Make a lightened black & white copy of your driver's license or your state Id card & enlarge 200%.(If unavailable click back to the state of your birth to see special instructions)
Step3. Sign all forms in black ink in all places.(NOTE: 2 signatures on our forms )
Step4. Fax all pages of the order forms and Photo ID to 1-800-856-2383.
You will get an emailed sales receipt within 2 business days, your order will start processing as soon as we recieve your fax, if there is a problem with your order we will call you. Don't use Moxilla/Firefox browser it doesn't print all pages. Note: You cannot use non-US issued credit cards or ship outside the US.
Fees: ** State Fee(which includes UPS return delivery): vary from $28-$69 Plus Our Service Fee: $64.00
The current state fees and process times are available if you click back on your browser..

Certified Birth Certificate Request
(Last 3 digits on the back of your credit card for Visa/Mast/Dis.or 4 on front of Amex) CVC-Code
Credit Card Number: Expires
Certificate Holders Name at Birth: (If adopted use adopted name and adopted parents names .)

(First)(Middle)(Last)
Fathers Name:
(First)(Middle)( Last)
Mother's Full Maiden Name: Maiden Last Name
(First) (Middle)( Maiden Last Name)
Certificate Holders Birth Date(MM/DD/YYYY) State of Birth
County or Borough of Birth City of Birth
*Adopted or Legal Name Change excluding Marriage Sex: of Certificate Holder     
Relathionship to certificate holder Is Certificate Holder Still Living ?
Person making this request Birth Date(MM/DD/YYYY)
Person making this request complete Social Security # Number of Copies
Hospital: Reason for request
Ship Method: UPS       Date of departure(If Needed for Travel):
Ship to Name:
Ship to Address:***
City State: : Zip:
Daytime Telephone #  ( ) -  - E-xtension:
Alternate Telephone #  ( ) -  - E-Mail
Applicant's Signature:_____________________________ Date :

I authorize USBirthcertificate.Net to obtain my birth certificate for me. By signing the form above I agree that I have read the order form completly and if the information that you have provided is incorrect, insufficient, or the government agency has no record of the birth that there are no refunds of USBirthcertificate.net's services fees for any reason . I understand that USBirthcertificate.net is a private expediting service and I am hiring them to expedite my birth certificate order. (We don't create, change or ammend birth records. We only retrieve existing records.) We cannot obtain birth certificates for Connecticut , Iowa , Puerto Rico or New Mexico. ALL SALES ARE FINAL.

ADDITIONAL OPTIONS:
Please charge me "total service fee $180" for our regular passport and birth certificate processing fee
To process or for questions see below or visit our passport section for additional instructions on passport processing.(Please note these fees don't include the government fee for processing a passport.)
Emergency Processing (Regular fee plus additional fee of $25.00)
Please note emergency processing doesn't change the stated State processing times it just puts your job in front of any regular job that came in before your job.
All Sales Final, Once a job is received by our office it can't be cancelled
***You must list a physical street address (No APO's , FPO's or PO Boxes) where someone can sign for the certificate. Please read the information on credit cards below..
You must contact us if the certificate does not arrive by the stated process time .
** State Fees may appearr on your credit card asVCN NETWORK, or VCN then State Name Or as
Bureau of Vital Statistics
If you will not be at your shipping address to sign for the overnight courier package when
it arrives, then you will need to leave a note at the address stating to please leave the package
at your door or wherever you specify then print and sign your name.I understand that US Birth
Certificate .Net is not responsible for any service performed by an overnight courier service.

Is the credit card in your name?If credit card holder is different from applicant please
also fax a photo ID. Name of Card Holder:

Signature of card holder:_____________________________________Date:
I authorize a charge to my credit card for the birth certificate request of (Certificate Holders name)
by US Birth Certificate. Net & the State of your birth.**
Credit Card Billing Address and phone number if different from shipping address:


CityState:
Zip:Phone
Please fax all pages of order form, and photo id of both the certificate holder
(if not a minor) and the credit card holder (if different from certificate holder )
...........................................
Toll Free Customer Service: 888-736-2692
Fax: 800-856-2383
Email: info@usbirthcertificate.net
.........................................

Your privacy is important to us. Click here to read our privacy policy.

Procedure for obtaining a passport and birth certificate: (If you are just getting a Birth Certificate please ignore these instructions listed below ):

Step 1: Follow instructions above or on our order form for a birth certificate, print, sign and fax it to us with a copy of your drivers license.

Step 2: Wait for your certificate to arrive, read and follow instructions on our passport website in the meantime by printing the passport requirement page and getting all requirements together.

Step 3: Once your birth certificate arrives and you have all the passport requirenments in front of you, call our office and let us verify that you have all the passport requirements then take all needed documents to your local acceptance agent (post office or county clerk to be sworn in and seal up all documents in a government sealed envelope).

Step 4: Federal Express two things to us: Sealed Envelope and our passport Order form.