Commonwealth Of Puerto Rico Birth Certificate Application By Mail printable pdf download

Commonwealth Of Puerto Rico Birth Certificate Application By Mail

RD-225

MOD 12/08

COMMONWEALTH OF PUERTO RICO

DEPARTMENT OF HEALTH

DEMOGRAPHIC REGISTRY

BIRTH CERTIFICATE APPLICATION BY MAIL

PART I: REGISTRANT’S INFORMATION

1. Name at birth:

________________

Father’s Last Name

Mother’s Last Name

First Name

Middle Name

3. Place of birth: (town and hospital)

2. Date of birth: (month/date/year)

4.Father’s Name:

5. Mother’s Name:

6. The certificate will be used for:

7. Number of copies:

Part II: APPLICANT’S INFORMATION*

2. Relationship:**

1.Applicant’s Name:

Father’s Last Name Mother’s Last Name First Name Middle Name

3. Applicant’s address:

4. Address where you want the certificate to be sent:

5. Applicant’s identification included:

Other

6. Applicant’s signature and date:

___Driver’s Lic, ___State ID, ___Passport, ___Public

Assistance, ___ Other

IMPORTANT: FIRST COPY $5.00 EACH / ADDITIONAL COPY $4.00 OF SAME PERSON

Applicants living out of Puerto Rico send the application to the following address: Demographic Registry PO Box 11854,

San Juan Puerto Rico 00910

If the applicant lives in Puerto Rico can visit any Local Registry near his/her house to complete an application.

Applicant must send a photocopy of a recent valid photo-identification card.

Applicant in Puerto Rico: Please send $5:00 internal Revenue Stamp for the first copy requested and $4.00 for each

additional copy for the same person.

Applicant out of Puerto Rico: Please send $5.00 Money Order payable to Secretary of the Treasury.

Please send a self-addressed-stamped-envelope to mail in your certificate.

For rush mail as Fedex, Exp. Mail, Registered, UPS, etc. our address is: 171 Quisqueya Street, Hato Rey, PR 00917

WRITE CLEARLY YOUR NAME AND ADDRESS

*Applicant – means registrant, their children over 18 years of age, legal representative.

**Relationship – relation between the applicant and the registrant. This blank will be filled out if applicant and

Registrant is not the same person.

Commonwealth Of Puerto Rico Birth Certificate Application By Mail

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