Clerk/Register of Deeds: Order Form -- Birth Records

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To obtain a birth certificate online, you (the applicant) are required to submit a copy of your driver's license or state identification to be submitted with this request. You may choose to upload your ID now or receive an email to submit later.

IMPORTANT: Your order will not be processed until we receive proof of identity within 2 business days.
Submission of ID option *
Are you eligible to request this birth record?
Eligibility * Please select one that applies to you:
Please enter information as it appears on birth record:
First Name *
Middle Name
Last Name *
Date of Birth *
City of Birth
First Name *
Middle Name
Last Name *
First Name
Middle Name
Last Name
Number of copies *
Reason for request
Applicant's information:
First Name *
Last Name *
Address Line 1 *
Address Line 2
City *
State *
E-mail Address *
Verify E-mail Address *
Statement of Entitlement:
I understand that misstating an identity or assuming the identity of another person is a crime. By entering my full name in the space provided below and transmitting this form electronically I state that I am the person named on the record or one of the parents named on the record that is being requested; in placing my name in the signature box below I am certifying that the information provided in this web application is complete and accurate; and I understand that the inclusion of false information in this application will subject me to the penalties of Michigan Compiled Laws 333.2894(b) and 333.2898, as well as, federal laws relating to falsification in obtaining a birth record.
Sign by typing your full name below.

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