Application For Certified Copy Of Birth Or Death Record - County Of Stanislaus
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1
2
3INSTRUCTIONS FOR REQUESTING A COPY OF A
BIRTH OR DEATH RECORD
1. Check which type of copy you are requesting:
a. For Authorized Certified Copies: You must complete the entire Application form, including the
Certificate of Identity Statement (see instructions below).
b. For Informational Copies: You are only required to complete the Applicant and Registrant
information sections of the application. The Certificate of Identity Statement/Certificate of
Acknowledgment is not required for an Informational copy.
2. “I am:” Section: Check the box that pertains to your relationship to the Registrant (person named on the
certificate).
3. Certificate of Identity Statement/Certificate of Acknowledgment (same page): Must be completed and
signed under penalty of perjury. If application is submitted in person, the Certificate of Identity Statement
must be signed in the presence of Clerk-Recorder Staff and no Certificate of Acknowledgment is required.
If you place your order by mail or the internet, you must complete and sign the sworn Certificate of
Identity Statement in the presence of a Notary Public and the Notary Public must complete the Certificate
of Acknowledgment (lower part of page) before submitting your request.
PLEASE NOTE: Only one notarized Certificate of Identity Statement/Certificate of Acknowledgment
is required for multiple certificates requested at the same time; however, the Certificate of Identity
Statement must include the name of each individual whose birth/death certificate you wish to obtain
and your relationship to that individual. The front portion of the application must be completed
for each individual you are requesting birth/death certificate copies for.
4. Fees: Fees may be paid by cash, check, money order, debit or credit card in the Clerk-Recorder’s Office.
Mail requests must be paid by personal check, postal or bank money order (International Money Order
only for out-of-country requests). Checks or money orders should be made payable to Stanislaus County
Clerk-Recorder.
a. Fees for copies or searches of Birth Certificates:
$28 for each copy or search*
b. Fees for copies or searches of Death Certificates:
$21 for each copy or search*
*If no record is found the fee is retained for the search effort (as required by statute).
5. Internet Orders: May be placed online through An additional fee of $7 is charged
by VitalChek for use of this service. Carefully follow all instructions from the VitalChek website when
placing your order. NOTE: The completed application and the Certificate of Identity
Statement/Certificate of Acknowledgment (see #3 above for instructions) must be submitted with
internet orders.
6. Mail Requests: Mail completed application, Certificate of Identity Statement/Certificate of
Acknowledgment (one page), appropriate fees, and a self-addressed stamped envelope to: Stanislaus
County Clerk, P. O. Box 1670, Modesto CA 95353-1670.
Stanislaus County Clerk-Recorder, P. O. Box 1670, Modesto, CA 95353-1670
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