Mdh Minnesota Certificate Of Birth Application
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3INSTRUCTIONS FOR COMPLETING
MINNESOTA CERTIFICATE OF BIRTH
APPLICATION (HUBBARD COUNTY)
Use this application only if you want a legal certified copy of a birth record and you were
born in Minnesota.
PART I: Birth Record Information
•
Make sure all boxes are complete to the best of your knowledge.
•
If you do not know information, please write “unknown.” However, if we are not able to positively
identify the birth record, we will return the application to you for more information or issue a
certified copy of No Birth Record Found ($26.00.)
•
If you are adopted and want a copy of your current, legal birth record, please use your adopted
name and adopted parents’ names.
•
If you are requesting certificates for more than one birth record, you must complete a separate
application for each record.
PART II: Tangible Interest
•
Minnesota law requires an individual to have “tangible interest” to obtain a birth certificate.
•
You must check one of the relationships listed in this section and you cannot add a relationship
not on the list.
•
You must attach documentation to prove your relationship to the subject when required.
PART III: Fee and Payment Information
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Please make your check or money order payable to: Hubbard County Recorder. Fees are
nonrefundable per Minnesota Statutes, section 144.226, subdivision 1.
PART IV: Requester and Notary Information
•
The requester is the person applying for the certificate, not the subject of the birth record.
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The requester’s date of birth is required to process the application.
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If you do not have a phone number or email address, please write “none.”
•
You must sign the application in front of a notary public and the notary must provide a signing
date.
•
The notary’s stamp or seal (if required in your state) must be readable on the application.
Mail your application and funds to:
Hubbard County Recorder
Attn: Vital Records
301 Court Ave.
Park Rapids, MN 56470
If you have questions, please contact us at 218-732-3552.
B102 REV 05/2010
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