State Of Rhode Island Report Of Adoption Page 2

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INSTRUCTIONS for Item 22:
The Clerk of the Court should complete this item, affix the seal of the court, and forward form to:
Division of Vital Records
3 Capitol Hill, Rm. 101
Providence, RI 02908-5097
NOTE: If this adopted child was born in another state or US territory, the RI state registrar shall forward this report to the state
registrar or other appropriate official at the place of birth.
FEES Required by Law:
There is a fee of $15.00 for processing the adoption and creating the new birth certificate. Make check payable to “General Treasurer, State of
Rhode Island” and send to the Division of Vital Records.
Certified copies of the new birth record will be issued to the parent(s) or the attorney after the processing fee is paid and a request for a
certified copy is made. The fee for one certified copy of a birth record is $20.00. Additional certified copies of the same birth record issued at
the same time are $15.00 each. Applications and information for obtaining certified copies of vital events can be found on our web site.

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