New Birth Certificate Application Requires County Action

minnesota department of health

New Birth Certificate Application Requires County Action


The Office of Vital Records (OVR) recently released a new version of the Minnesota Department of Health (MDH) Birth Certificate Application for statewide use. The release of the updated form helps Minnesota’s vital records system move closer to achieving uniform service delivery and standardization across the state.

Take action by January 31, 2018

  • Adopt the MDH Birth Certificate Application form in its entirety; or,
  • Adopt page one of the MDH Birth Certificate Application form and use office-specific instructions for fees and additional services; or
  • Update your form to match the tangible interest section of the MDH Birth Certificate Application.
  • Inform OVR of the action your office took and supply a copy or link to your form if you choose not to use the MDH Birth Certificate Application. Send your confirmation and information to: .
  • Remove and recycle old applications from public use.
  • Update your county website with accurate information and working links.


The new application incorporates suggestions from County Vital Records Offices, feedback from customers and the public, and ideas from OVR:

  • The application is dated 12/2017 in the lower right corner and is branded with the Minnesota logo.
  • The document is accessible and uses plain language as required by law.
  • A new section on public and confidential records informs customers that some records are restricted and helps explain why they may not get a certificate.
  • The tangible interest section is divided into Public (lines 1-14) and Confidential (lines 15-19) and allows the requestor to check more than one tangible interest. (When entering a MR&C customer service request, choose one tangible interest that best fits the situation.)
  • Please note: an authorized representative with a signed statement (line 14) has tangible interest ONLY for public birth records.

Prompts help the requestor complete the form correctly:

  • Instructions are at the top of the form.
  • New labels indicate where information for the subject, the parent(s) and the requester belong.
  • When supporting documentation is required, it is noted in the tangible interest line.
  • Information tells customers that counties may have different payment options and services.


Please accept any fully executed Minnesota birth certificate application if a customer brings or mails it in.


If you have questions about the new application, how to update your form, or why county-developed or customized birth certificate applications need to be updated, contact or