VS 111 — Application for Certified Copy of Birth Record (California)

What is VS 111?

Form VS 111, Application for Certified Copy of Birth Record, is how you order a certified copy of a California birth certificate by mail from the California Department of Public Health – Vital Records (CDPH-VR) in Sacramento. CDPH-VR issues records for births anywhere in California; a county recorder can issue records only for births in that county. Birth records are available 21 days after the date of the event.

There are two kinds of certified copy. An authorized copy can be used to establish the identity of the person named on the certificate. Only authorized people — the registrant, their parent, legal guardian, child, grandparent, grandchild, sibling, spouse or domestic partner, and certain court-ordered parties, attorneys, government agencies and estate representatives — can get one, and they must include the notarized sworn statement on page 5. Anyone else can get a certified informational copy, marked "Informational, Not a Valid Document to Establish Identity", with no sworn statement.

FileIt asks each question in plain English, prints your answers into CDPH's own PDF, and carries your name and the registrant's name over to the sworn statement for an authorized copy. The finished packet is saved in your vault. You sign the sworn statement in front of a notary and mail the application with your payment yourself.

Who needs to fill out VS 111?

• People born in California who need a certified birth certificate for a passport, REAL ID, school or benefits.
• Parents, legal guardians, children, grandparents, grandchildren, siblings, spouses and domestic partners of the person on the record.
• Attorneys, executors, people holding a power of attorney and others acting for the registrant or their estate.
• Law enforcement and government agencies conducting official business, which fill in the Agency Use box and are exempt from the notary requirement.
• Genealogists and anyone else who needs an informational copy.

When to use VS 111

• When you want to order a California birth certificate by mail from the state office rather than a county recorder.
• When you need an authorized copy to prove identity and can have the sworn statement notarized.
• When an informational copy is enough, for example for family history.
• When you are an adoptee requesting your original sealed birth record with a court order releasing it.

What you need before you start

• The registrant's first, middle and last name, city and county of birth in California, and date of birth (or an approximate date).
• Each parent's first name and last name at birth.
• Your name, mailing address, phone, email and reason for the request.
• For an authorized copy: a notary public to witness your signature on the sworn statement, and any documentation the relationship box asks for (guardianship papers, court order, power of attorney or executor documents).
• A check or money order for $31.00 per copy, payable to CDPH-Vital Records, in US dollars.

What’s on VS 111

The 2026 edition has 8 pages. FileIt asks for it in 7 parts, and it is signed by Applicant:

1. Certificate type and your relationshipApplicant
2. Part 2 — Birth record informationApplicant
3. Part 3 — Applicant informationApplicant
4. Agency useApplicant
5. Copies and paymentApplicant
6. Sworn statement (authorized copy)Applicant
7. Other records you are requesting at the same timeApplicant

How to fill out VS 111, step by step

1 Certificate type

Choose an authorized copy (notarized sworn statement required) or an informational copy. Only the people listed in Part 1 may obtain an authorized copy; everyone else receives an informational copy.

2 Part 1: Relationship to the registrant

For an authorized copy, check the box that describes you: the registrant or close family; a party entitled by court order or an attorney or adoption agency under Family Code Section 3140 or 7603; a law enforcement or government agency representative; a person or agency empowered by statute or appointed by a court to act for the registrant or their estate; or an attorney representing the registrant or their estate.

3 Part 2: Birth record information

Complete it as shown on the birth record, with as much information as possible. If the person was adopted, enter the adopted name to get the current record. To request the original birth certificate of an adoptee, include a court order releasing the original sealed record and check "Requesting sealed record".

4 Part 3: Applicant information

Enter your name, mailing address, phone, email and the reason for the request. A law enforcement or government agency also fills in the Agency Use box with its name and any case, ID or contract number.

5 Copies and payment

Enter the number of copies and enclose $31.00 for each copy as a check or money order payable to "CDPH-Vital Records" in US dollars. Do not send cash. Use a separate application for each birth record.

6 Sworn statement (authorized copies)

On page 5, declare under penalty of perjury that you are an authorized person, listing each registrant and your relationship to them — one sworn statement can cover several records requested together. The date and place line must be completed in the presence of a notary public, who then completes the certificate of acknowledgement. Law enforcement and government agencies are exempt from notarization but must complete the top of the sworn statement.

Common mistakes to avoid

• Requesting an authorized copy without the notarized sworn statement — CDPH-VR will not accept the request.
• Signing the sworn statement before you are in front of the notary.
• Putting more than one birth record on one application — each record needs its own application.
• Sending cash, or a check not in US dollars or not payable to CDPH-Vital Records.
• Asking for a copy of a record that is still being amended, when it's the amended record you want — wait until the amendment is completed.
• Using a foreign notary without an apostille, unless the notarization was done by a U.S. consular officer or a judge of a court of record.

After you fill it out

Print the packet. For an authorized copy, sign the sworn statement in front of a notary. Mail the application, sworn statement and payment to California Department of Public Health, Vital Records – MS 5103, P.O. Box 997410, Sacramento, CA 95899-7410. FileIt keeps a copy in your vault.

If your request is not accepted (for example for an insufficient fee or information), it is returned with a letter explaining what to correct. If CDPH-VR can't locate the record, the law lets it keep the fee for the search and it issues a Certificate of No Public Record. Current processing times are on the CDPH-VR website; if you need a copy sooner, the form lists the county recorder offices.

When the certificate arrives, scan it into your FileIt vault so it's ready for passport and ID applications.

VS 111: frequently asked questions

Official sources

• Blank form (PDF), published by California Department of Public Health, Vital Records: https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/VS111.pdf
• Official instructions and guidance: https://www.cdph.ca.gov/Programs/CHSI/Pages/Birth-Certificates.aspx
• Edition shown on this page: VS 111 (01/2026), with sworn statement VS 20 (07/2024) (checked 2026-09-28).

FileIt is not affiliated with or endorsed by California Department of Public Health, Vital Records or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-09-28.

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