Birth Certificate Request Form - CNMI Healthcare
This Birth Certificate Request Form from the Commonwealth Healthcare Corporation is essential for individuals seeking a certified copy of their birth certificate. The form is designed to ensure that only eligible individuals can obtain vital records in compliance with CNMI laws. Complete this form accurately to facilitate your request efficiently.
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How do I fill this out?
Filling out the Birth Certificate Request Form is crucial for ensuring your request is processed smoothly. Begin by checking your eligibility based on the criteria provided. Prepare all necessary identification and supporting documents before submitting the form.

How to fill out the Birth Certificate Request Form - CNMI Healthcare?
1
Determine your eligibility to request the birth certificate.
2
Complete the application form with accurate personal information.
3
Attach valid photo identification as specified.
4
Enclose any required documentation such as proof of guardianship or a court order.
5
Submit the form along with the payment to the specified address.
Who needs the Birth Certificate Request Form - CNMI Healthcare?
1
A registrant aged 18 years or older needs this form to obtain their birth certificate.
2
A legal guardian must fill out this form to request a birth certificate for their ward.
3
Parents listed on the birth record require the form to get a certified copy.
4
A legal representative may need this form to acquire a birth certificate on behalf of the eligible person.
5
Individuals with a court order must use this form to obtain authorized records.
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Select the areas of the document you wish to edit.
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What are the instructions for submitting this form?
To submit the Birth Certificate Request Form, you can mail it to the Health & Vital Statistics Office at PO Box 500409, Saipan MP 96950. It is vital to include a valid check or money order for the processing fee. For inquiries, you may reach out via telephone at (670) 234-8950 Ext: 2141 or send a fax to (670) 233-8756.
What are the important dates for this form in 2024 and 2025?
Please be aware that the submission deadlines for vital records applications may vary. It is advisable to submit your birth certificate requests at least six weeks before any significant date, such as court dates or travel plans. Keep an eye on processing times and plan accordingly.

What is the purpose of this form?
The Birth Certificate Request Form serves to facilitate the official documentation process for individuals needing certified copies of their birth records. It is an integral part of the Vital Statistics Act designed to protect the privacy and integrity of vital records. By requiring specific eligibility criteria and valid identification, this form ensures that birth certificates are issued to the rightful applicants.

Tell me about this form and its components and fields line-by-line.

- 1. Full Name of Person Requesting: This field requires the full name of the individual submitting the request.
- 2. Date of Birth: The requestor must enter their date of birth to verify identity.
- 3. Parent's Name: Names of the parents as listed on the birth record are required for verification.
- 4. Mailing Address: The requestor must provide a current mailing address for the delivery of the certificate.
- 5. Contact Information: A valid email and telephone number are necessary for any necessary correspondence.
- 6. Reason for Request: Indicates the purpose for which the birth certificate is being requested.
What happens if I fail to submit this form?
Failing to submit the Birth Certificate Request Form properly may lead to delays or rejection of your application. It is crucial to ensure that all fields are accurately filled and that required documents accompany the form. Double-checking your submission can prevent complications in obtaining your vital records.
- Incomplete Information: Incomplete fields can result in application denial.
- Missing Documents: Failure to attach required documents simplifies processing.
- Incorrect Identification: Providing invalid ID will halt your request.
How do I know when to use this form?

- 1. Legal Requirement: Required for legal identification in various circumstances.
- 2. Travel Documents: Often needed when applying for passports or visas.
- 3. Civic Functions: Necessary for marriage licenses and adoption paperwork.
Frequently Asked Questions
Who is eligible to request a birth certificate?
Only the registrant, parents, legal guardians, or authorized representatives with proof can request the certificate.
What identification is required?
A valid photo ID is necessary when submitting the request form.
How long will it take to receive the birth certificate?
Mailing of the completed certificates typically takes 2-3 weeks.
Can I edit the PDF prior to submission?
Yes, you can easily edit the PDF using PrintFriendly before downloading.
What payment methods are accepted?
You can pay by check or money order made out to Commonwealth Healthcare Corporation.
What should I do if my application is denied?
Review the denial notice for required corrections and reapply as needed.
Is there a service fee?
Yes, a service fee for mailing all certificates applies.
Can I submit the form online?
Currently, submissions are done via mail after completing the form.
How do I get a notarized affidavit?
Consult a notary public to create an affidavit if required for your request.
What if I changed my name since birth?
Indicate your new name on the form and provide supporting documentation.
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