Affordable Birth Certificate Passport & Visa Expeding Service-Fast Certified Birth Certificates from each state. Can be used to travel. Passport service 1-6 days for new passports.

BirthCertificatePassports.com

What you will need to do is fill out the form below and hit the print button on your browser.Then make a copy of your driver’s license or your state issued identification card (if available) (for minor children please make a copy of the parents(s) drivers license or state issued ID card) and fax both to us at (281) 416-9554. You MUST have a Visa, Mastercard, American Express or Discover number on the form below as this is how the states will charge you for your Birth Certificate We cannot obtain birth certificates for Connecticut, Hawaii, and New Mexico.

PLEASE USE CAPITAL LETTERS ON THE FORM BELOW. All Sales Final. Promotion Code: default
Debit cards may be used.
Fees: State Fee: $22.00-89.00 (Most are $35-$40) Plus Our Fee: $49.00

Please charge me "total service fee $147" for passport and birth certificate processing
Emergency Birth Certificate Processing (Additional Fee $25.00)
2-6 Day California walkthrough service, ALL fees included $167.00
(Required for all California Adoptions and Name Change)

Certified Birth Certificate Request

Credit Card Number : Expires V- Code Required

Required for VISA & MASTERCARD ONLY V Code is the 3 digit number on the back for your credit card. The V code is located in the signature line and is usually the last thre numbers directly after your credit card number. (Some cards do not have the credit card number listed, so in this case the V Code is the last 3 numbers.)

Exact Name on Credit Card :

Address Credit Card Bill Goes To :

Certificate Holders Name at Birth:

(First)(Middle)(Last)

Fathers Name:

(First)(Middle)(Last)

Mother’s Full Maiden Name:

(First) (Middle)(Last)
Social Security Number:

Birth Date State of Birth

Adopted County City

If adopted use adopted name and adopted parents names, Pre-adopted certificates are unavailable.

Hospital: Sex: Number of Copies

Ship Method: Express Courier Date of departure:

Ship to Name:

Ship to Address:***

City: State : Zip:

Daytime Telephone # ( ) - - Email:

Other Telephone # ( ) - -

Signature:___________________________________ Date :

I authorize birthcertificatepassports.com or their representative to obtain my birth certificate for me.
Due to the expedited nature of our service we do not cancel orders after they are placed.
By signing the form above I agree that there are no refunds of BirthCertificatePassports.com's services fees above for any reason.
I understand that birthcertificatepasports.com is not responsible for any service performed by any overnight courier service or government agency.
I understand that birthcertificatepassports.com can not control the process time by Individual state agencies.
Process times may vary based on workload of state agencies.
You will recieve 2 charges on your credit card... Our service fee plus a seperate charge by the State for any state fees and delivery charges.
State Fees may appear on your credit card as VCN NETWORK, or VCN then State Name or as Bureau of Vital Statistics.
Please contact us if the certificate does not arrive by the stated process time

CLICK HERE FOR CALIFORNIA BIRTH CERTIFICATES
YOU MUST ALSO FILL IN THIS PDF.
FORM AND FAX ALONG WITH OUR FORM.

Yes, I want “Emergency Processing Service” for my Birth Certificate charge me additional fee $25.00

All Sales Final

• YOU MUST ALSO FAX A COPY OF YOUR DRIVERS LICENSE
   Please lighten & enlarge the COPY of your drivers license before faxing.
   NO scanned images please.
• Please contact us if the certificate does not arrive by the stated process time.
• Your privacy is important to us. Click here to read our privacy statement.
• A parent must request birth certificates for minor children.
• We can not process this request without a signature.
   Please sign this form in two places before faxing.

***You must list a physical street address (No APO's , FPO's or PO Boxes) where someone can sign for the certificate

Credit Card Orders....
Is the credit card in your name?
If NO...please also fax photo ID of certificate holder & credit card holder. Have credit card holder sign authorization below & certificate holder above.

If YES... please sign the order form above & authorization below & fax both pages with a photo ID.

Print name of the credit card holder: _______________________________________

Signature of credit card holder: ___________________________________

Date: ___________________________________

I authorize to charge my credit card for the birth certificate request of ____________________________________________________________________
(certificate holder name at birth)
by Birth Certificate Passport & Visa Specialists

Credit Card Billing Address and phone number if different from shipping address:
**( if left blank and your shipping address does not match your billing address...your order will not be processed)
Print Address : ____________________________ State : ____________ Zip: _________
Phone : _______________________________

Please fax both pages of order form and photo ID of both the certificate holder (if not a minor) and the credit card holder (if different from certificate holder).

How did you hear about us? Search Engine, Ad, Referral ???
(If Search Engine....what keywords did you use ?)
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