Birth Or Death Certificate Application - Tarrant County

ADVERTISEMENT

MARY LOUISE GARCIA
COUNTY CLERK
200 TAYLOR ST. STE. 301, FORT WORTH, TX, 76102
BIRTH OR DEATH CERTIFICATE APPLICATION
*Please see back of form for complete instructions and eligibility requirements*
A NON-REFUNDABLE SEARCH FEE WILL APPLY FOR ALL RECORDS NOT FOUND
$22.00 Birth Certificate Search Fee - $20.00 Death Certificate Search Fee
Health and Safety Code 191.0045 (a) (1), (e) (3)
1. BIRTH
EACH CERTIFIED COPY IS $23
HOW MANY? _________
*Abstract will be issued if Tarrant County is not the local registrar. Abstracts may not be suitable for a passport*
First Name
Middle Name
Last Name
2.
Date of Birth
City or Town
County
State
3.
Father's First Name
Middle Name
Last Name
4.
Mother's First Name
Middle Name
Maiden Name
5.
1. DEATH
FIRST CERTIFIED COPY IS $21
ADDITIONAL COPIES OF THE SAME RECORD ARE $4 EACH
HOW MANY? _________
First Name
Middle Name
Last Name
2.
Date of Death
City or Town
County
State
3.
Father's First Name
Middle Name
Last Name
4.
Mother's First Name
Middle Name
Maiden Name
5.
What is your relationship to the person on the record? _____________________________________________
State your reason for obtaining certificate (PLEASE BE SPECIFIC):______________________________________________
If mailed, please include a legible photocopy of your valid Government
Issued ID, a self-addressed stamped envelope and a check or money
order made payable to:
Signature of Applicant
MARY LOUISE GARCIA, COUNTY CLERK
Address of Applicant
And mail to:
200 Taylor St., Suite 301
Fort Worth, TX 76102
Phone Number
*All mail requests are completed within 72 hours from time
WARNING: THE PENALTY FOR KNOWINGLY MAKING A FALSE STATEMENT IN THIS FORM CAN BE 2-10 YEARS
IN PRISON AND A FINE OF UP TO $10,000. (HEALTH AND SAFETY CODE, CHAPTER 195 SEC.195.003)
OFFICE USE ONLY
Issued to:_________________________________________________ Date issued__________________
Type of I. D.______________________________ Control #______________________ Clerk Initials ____________

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 2