Kaitlin's Wish

Office of Vital Records

Certificate of Birth Resulting in Stillbirth

In 2001 the Arizona Legislature established a new certificate entitled "Certificate of Birth Resulting in Stillbirth." This new certificate became available from the Office of Vital Records beginning August 9, 2001.

Certified copies of a Certificate of Birth Resulting in Stillbirth cost $10.00 each and can be requested in person at the customer service counter at the Office of Vital Records or by mail.

Applications are available in the lobby of the Office of Vital Records and may also be printed from this web site.

Who may order and obtain a certified copy of a Certificate of Birth Resulting in Stillbirth?

Please note: Arizona is a "closed record" state. That means that vital records are not public record. Arizona law restricts the public's access to vital records as follows:

Only persons 18 years of age or older may obtain a certified copy of a birth certificate. In addition, to protect the confidentiality rights of our citizens, Arizona law specifies that only the following may receive a certified copy of a certificate of birth resulting in stillbirth. In addition to meeting the age and eligibility requirements you must also provide proof of your relationship to the registrant or your legal interest and a valid government issued picture I.D. in order to obtain a certified copy.

The parent or parents of the stillborn child (registrant).
The registrant's grandparent. (You must provide proof of your relationship such as the birth certificate of the registrant's parent.)
An adult brother or sister of the registrant. (You must provide proof of your relationship such as a certified copy of your birth certificate.)
An attorney representing the registrant's parents in matters involving the registrant or the registrant's parents. (You must provide documentary evidence of your status of legal interest.)
Any person or agency empowered by statute or appointed by a court to act on the registrant's behalf.
A federal, state or local governmental agency which requires the copy for official purposes.
A governmental agency acting on behalf of the registrant to process a financial claim, benefit, award or other compensation or to transact official business involving the registrant or the registrant's affairs.
A family member, or relative of the registrant engaged in research for genealogical purposes who provides proof of relationship to the registrant.

An incomplete application will delay the processing of your request. A complete application, whether applying in person or by mail must have all of the following information:

The name of the stillborn if named.
The date of birth resulting in stillbirth.
The place of birth resulting in stillbirth (hospital or residence and city or town and county).
The name of the hospital or facility.
The maiden name of the mother.
The full name of the father.
The number of certified copies being requested.
A complete mailing address where you want us to mail the certified copies.
A daytime telephone number where we can reach you if there is a problem.
Your signature. (Notarized when applying by mail.)

Applying in Person:

When applying in person you will need to complete an application, available in the lobby, with the information listed above.

You will also need to have valid government issued photo identification and pay the applicable fees at the time of application. Certified copies are $10.00 each and are NOT available the same day the request for certified copies is made. We accept cash, traveler's checks, cashier's checks, or money orders in the exact amount at our customer service counter. We also accept Visa and MasterCard credit cards and debit cards at the counter. Copies will be mailed to the applicant within 8 days of the day we receive the application.

Applying by Mail:

When applying by mail, you will need to complete an application with the information listed above. You may provide this in the form of a letter or you may click here to download a printable copy of the application. An incomplete application will delay the processing of your request.

You will also need to send a clear photocopy of your valid government issued photo identification and enclose the applicable fees. Certified copies are $10.00 each and will be mailed to the applicant within 4 to 6 weeks of the day we receive the application.

When applying by mail, we accept traveler's checks, cashier's checks, and money orders in the exact amount only and made payable to The Office of Vital Records. We also accept debit cards and MasterCard and Visa credit cards. If you choose to pay by debit or credit card, please write the full card number and expiration date and print your name as it appears on the card on your application and sign it. Please Do not send cash.