Instructions to File a Delayed Certificate of Birth in Missouri
(Only a person who is now 12 years of age or older born in Missouri currently without a registered birth certificate will utilize this process to record their birth and create a delayed birth certificate)
- AFFIDAVIT on Page 1:
- Give the facts as of the time of your birth. (If you have been adopted, write to the Bureau of Vital Records for special instructions.)
- Registrant must sign in present legal name in the presence of a notary public and include the notary’s signature, date of signature, and date of expiration of commission. (The notary should not be related to registrant.)
- AFFIDAVIT on Page 2:
- Have a parent prepare and sign the Supporting Affidavit before a notary public.
- If both parents are deceased, have an OLDER relative or an OLDER long-time acquaintance prepare the affidavit. This person must state how he came to know about your date and place of birth. (Not husband/wife.)
- TWO DOCUMENTS (of different types) are required to verify your name, date and place of birth. (Suggested documents may be found below.)
- Observe the following as each document must show:
- Your full correct name when you were born.
- Your correct birth date and place of birth, and one document must give parents names.
- The source of the document (its name and location).
- The date the document was made (filed). (The document must be over 5 years old.)
- The older the document, the stronger its probative value.
- An altered document is not acceptable.
- Personal knowledge affidavits are not accepted in lieu of documents.
Return your application, two documents, and proper fee. (Documents MUST accompany the application.)
- A certified copy of the certificate, or any part of it, is $15.00.
- A fee of $15.00 if required for processing.
- Make check or money order payable to: Missouri Department of Health. Jefferson City Missouri.
Other forms of remittance at sender’s risk.
Additional Information
- The Bureau of Vital Records was established in 1910. Delayed registration of persons born prior to 1910 was begun in 1931, and then only by request.
- The Bureau of Vital Records has authorized NO ONE to represent it for handling delayed certificates. Do not give money to anyone who claims to be an agent of this office.
- If you are 62 or over, contact the Social Security Board local office, your county Welfare office, the Railroad Retirement Board, etc, regarding their requirements before submitting your application to the Bureau of Vital Records.
- Every state has a procedure to file a delayed birth certificate. You should make every effort to file in your state of birth.
- A delayed birth certificate cannot be filed for a deceased person. (His death certificate gives all the data which would appear on the delayed birth certificate. The death certificate also includes citizenship.)
- A delayed certificate that is incorrect or inadequate can be changed by COURT ORDER ONLY.
(The delayed birth certificate application form and these instructions have been filed with the Missouri Secretary of State to conform with law.)
SUGGESTED DOCUMENTS
(Send two)
Baptismal, Cradle Roll, or other Church Record
If the registrant does not have such record, he should write to the present pastor of the church where the record was created. If the record is in a foreign language, the essential information should be translated. The officer holding the record shall certify to the facts using his official title and seal or letterhead. The name and date of birth or age must appear on the record.
Physician, Dentist, Optometrist, or Hospital Record
Can be either a copy of a record in their files or a statement on their stationery that states registrant’s full name at birth, date of birth, name and address of the physician or hospital, and date you were first seen by the doctor or admitted to the hospital. Document must be over 5 years old.
Child’s Birth Record
Must be obtained from the State Vital Records Office in the state the child was born. Must show your full name, age, place of birth, child’s full name, child’s date of birth, state file number, and must bear the state seal. Hospital birth records are not acceptable. Document must be over 5 years old. If an amendment has been made on the child’s birth record, the amendment must be over 5 years old.
Insurance Policy (Life, Health, and Accident, Hospital, Burial Benefits, etc.)
Most insurance policies are excellent documents since they usually carry the registrant’s name, exact date and place of birth and date policy application was made. Be sure your policy is five or more years old. If the policy is not now in your possession for any reason, write the Company for the information you need. DO NOT SEND A STATEMENT BASED ON A POLICY UNLESS IT IS PREPARED BY THE COMPANY’S AGENT FROM HIS RECORDS. An affidavit regarding a policy cannot be accepted. Policy must give name and address if company.
Military Record
Must show your full name, date of birth, place of birth, date you entered the service, your service number, and the date you were discharged.
School Record or School Enumeration Record
Applicant may be able to obtain a record from the superintendent of the school attended, the county superintendent of schools, or the county clerk. The record must show age or date of birth, birthplace, and the date record was prepared. The officer holding the record shall certify to these facts using the official title and seal or letterhead.
Employment Application
Can be either a copy of the records in their files or a statement on their stationery that states your full name, date of birth, date you applied for the job or the date you were hired and the company’s name and address. This may be obtained from their Personal Office. Document must be over 5 years old.
Voter Registration Application
Obtained from the County Clerk’s office. Must show your full name at birth, date of birth, place of birth, county and state registered in, and the date you registered. Document must be over 5 years old.
Social Security Numident
This is a computer print-out of the application that you completed at the time you applied for your Social Security Number and can be obtained from your local Social Security Office.
Marriage License Application
Obtained from the Recorder of Deeds Office in the county you obtained your marriage license. Must show your full name, age, date applied, county and state where you obtained your license, and must be over 5 years old.
Many more acceptable records are available. If you have two that fit your affidavit on Page 1, send them for review. Driver’s licenses, fraternal order membership applications, and U.S. Passport are a few other suggestions. Rarely does a registrant fail to have several acceptable documents.
Appeal of Decision
If at any time in this process, the State Registrar has cause to question the validity or adequacy of the applicant’s statement or the documentary evidence, and if the deficiencies are not corrected, the State Registrar shall not register the birth. If the State Registrar does not register the Certificate of Live Birth, you may appeal the Bureau’s decision to a court of competent jurisdiction and obtain a court order to create a birth certificate for the child.
