Wayne County Clerk Birth Certificate Application - VitalChek - wayne county clerk s office

---

• (1) Wayne county clerk office birth certificate
• (2) Wayne county clerk's office address
• (3) Wayne county clerk's office wv
• (4) Wayne county clerk office detroit

Birth
Wayne County Clerk
Certificate Application
(LexisNexis VitalChek Network Inc. is in partnership with the Wayne County Clerk to enable enhanced electronic processing of mail-in vital record applications.)
Please follow the instructions below when submitting your application.
Before completing your request, please note the following information:
? For City of Detroit birth certificates, please use the CITY OF DETROIT Birth Certificate Application (http://vitalchek.com/Fax-
Phone/MI_DETROIT_BIRTH_Applications.pdf)
? THE WAYNE COUNTY CLERK MAY, AT ANY TIME, REQUEST ADDITIONAL DOCUMENTATION TO HELP DETERMINE THE IDENTITY
OR ELIGIBILITY OF THE APPLICANT.
? Births that took place prior to October of 1978 THAT DO NOT HAVE THE FATHER LISTED ON THE BIRTH CERTIFICATE, are
maintained by the State of Michigan and are NOT AVAILABLE at the Wayne County Clerk's Office.
? Only the persons named on the certificate (Mother, Father, or Child), a legal guardian or a legal representative are eligible to
receive Wayne County birth certificates.
SEND WITH COMPLETED APPLICATION
1. For each individual certificate being requested, the following information must be submitted:
? A separate application form must be sent for each person's requested certificate.
? Payment must be included for the total request, including a separate VitalChek Processing Fee for each individual
application.
? If you are submitting multiple applications at the same time, all with the same delivery address, you will only
need to include payment for one (1) Delivery Method, not one for each individual application.
? Appropriate current identification, as listed on the table below, is required for each application (expired IDs are
not accepted).
Choose 1 Primary ID, OR at least 2 Secondary IDs with signature (if Primary ID is not available)
PRIMARY ID Valid, unexpired State-issued driver's license Valid, unexpired State-issued ID Card (non-driver)
(1)
OR
SECONDARY Social Security Card Current pay stub along with Work ID
ID WITH
SIGNATURE Voter registration card School ID
(2 or more) Valid passport Current utility bill showing full name and address
? If you are not one of the persons named on the birth certificate, please visit the Wayne County Clerk website
(http://www.waynecounty.com/clerk/birth_certificates.htm) for proper instructions to request the certificate.
2. Please mail your completed application, along with identification and additional documentation (if required) to:
Vital Record Mail Services
ATTN: Wayne County Clerk For expedited order placement and processing
P.O. Box 222130 please visit www.VitalChek.com.
El Paso, TX 79912
Please don't include a pre-paid express mail envelope with your request. This will cause a delay in delivery.
You must select a delivery method on the next page.
3. Please allow 5 - 7 business days for your application to be received prior to calling our customer service department with
any questions about your application. We can be reached toll-free at 866-585-2258.
IDENTITY THEFT PROTECTION ACT 445.65(1) and 445.69(1) prohibit anyone from obtaining a vital record by misrepresenting a person's
identity or attempting to use another person's identifying information. A person who violates this law is guilty of a felony punishable
by imprisonment for up to 5 years or a fine of up to $25,000 or both.
WCC-MI-B 121218-A
Birt
FOR VITALCHEK USE ONLY
Wayne County Clerk
h Certificate Application Order # __________________
NOTE: This form should be used ONLY by a person named on the Wayne County certificate, a legal guardian or legal representative.
DO NOT USE THIS FORM FOR CITY OF DETROIT REQUESTS - please use the separate City of Detroit Application.
STEP 1: CERTIFICATE INFORMATION
fFirustllnNamaeme of Child at Time of Birth (CertificatmeidHdoleldnaemr)e last name suffix
f
Father's Full Name
f
irst name middle name last name suffix
Mother's Full Maiden Name
irst name middle name maiden last name
Date of Birth (MM/DD/YYYY) City of Birth (NO DETROIT BIRTHS) Gender Male Still Living Yes
Female No
Reason for Request
STEP 2: YOUR INFORMATION AND SHIPPING ADDRESS
fYirostunraFmuell Name (Applicant) middle name last name suffix
Your Street Address City State Zip Code
Your Relationship to Person Named on Certificate E-mail Address (for communication & status updates) Daytime Phone Number
f
Name and Address to Send Certificate (if different than noted above)
irst name middle name last name suffix
Ship To Address City State Zip Code
Your Signature (Applicant) Date of Application
STEP 3: COST
Certificate Costs TOTAL A = $________ Delivery Method * (You MUST select one) TOTAL C = $________*
Certified copy (1st copy) = $24.00 UPS Next Day Air = $19.75 UPS Alaska, Hawaii, Puerto Rico = $22.00
___ Additional copies = $7.00 ea UPS Second Day Air = $16.00 UPS Worldwide Expedited = $34.50
Senior Citizen copy (Age 65+) = $2.00 UPS Canada or Mexico = $23.00 U.S. Postal Service Regular Mail = $ 0.00
___ Additional Senior copies = $3.00 ea UPS will not deliver to a P.O. Box. Processing time may take 7-10 business days.
* If submitting multiple applications at one time, all with the same delivery address, only include payment
VitalChek Processing & Handling for one (1) Delivery Method, not one for each application.
(non-refundable) TOTAL B = $ 6.50 TOTAL AMOUNT DUE (A+B+C) = $
STEP 4: PAYMENT INFORMATION
Select Payment Method: DO NOT SEND CASH Submit separate payment for each Application
Credit Card Credit Card # ______________________________ Expiration Date ________ Cardholder Signature ________________________________
Charges will appear on your Credit Card statement as: VCN*WAYNECOMAILROOM
Personal or Business Check If paying by personal or business check, please make payable to VITALCHEK.
STEP 5: MAIL YOUR SIGNED AND COMPLETED FORM For expedited order placement
Please mail your completed form, along with ID and additional documentation (if required) to: and processing please visit
Vital Record Mail Services www.VitalChek.com.
ATTN: Wayne County Clerk
P.O. Box 222130
El Paso, TX 79912
Please don't include a pre-paid express mail envelope with your request. Select a delivery method above. WCC-MI-121218-A


What department is Wayne County in? Town and Country Fire and EMS, Ohio Department of Transportation, Wayne County Sheriff’s Office and the Wayne County Coroner’s Office assisted at the scene. The crash is still under investigation.

• Circuit Court Clerks - Mississippi
• Rev. 3/2022 NAME CHANGE INSTRUCTIONS FOR PERSONS …
• APPLICATION FOR ABSENTEE BALLOT BY MAIL ONLY IN
• County NY Historian
• Clerk - Wayne County Home Page