Nebraska-Born Certified Birth Certificate Application

Internet Application processing time is 7 to 10 working days sent by standard US mail.
As of July 1, 2014 all birth certificates are $17.00 each.


You must meet Proper Purpose Regulations to make an application for birth certificate.

Genealogy Applications must be requested by mail and not through the Internet.

The Certificate of Birth Resulting in Stillbirth is not available by Internet.

Go back to Vital Records Home Page

The application will be processed once we have received and accepted
a readable copy of the requestor's current government-issued photo identification,
such as a current driver's license, passport, military ID, or state ID.

 The ID must be received in our office within three (3) business days

Use one of the following methods to submit the requestor's ID
    • Use a Smartphone (or digital camera), take a photo of the requestor's ID, and
    email to: DHHS.VitalRecords@nebraska.gov
    • Use a scanner, acquire a copy of the requestor's ID, and
    email to: DHHS.VitalRecords@nebraska.gov
    • Fax a copy of the requestor's ID to (402) 742-2385
    NOTE: Please enlarge 200% and lighten image before faxing.

    Acceptable image formats are .JPG, .BMP, .DOC, .PDF and .TIF

    Please include the Confirmation Number provided when you have
    completed the application and the name(s) on the record

Please complete the form below

Full Name at Birth: (If adopted, list adoptive name.)
First Name: *
Middle Name: * If no middle name, enter "None"
Last Name: *
Date of Birth: ( Month, Day, and Year of Birth )
Date:    Month Day Year *
Location of Birth: ( City and County )
City of Birth: *
County of Birth: *
Father's Full Name: (If adopted, list adoptive father's name.)
First Name: *
Middle Name: * If no middle name, enter "None"
Last Name: *
Mother's Full Maiden Name: (If adopted, list adoptive mother's name.)
First Name: *
Middle Name: * If no middle name, enter "None"
Last Name: *
General Information
Is this the record of an adopted person? YES NO *
For what purpose is this record to be used?
*
How are you related to the person named on the birth certificate that you are applying for?
If this is your record, please enter 'self'
*
Comment(s):


Please re-read all the information on this form for its accuracy.
When you are satisfied that the information listed above is correct.
Click on the "Submit Birth Information" button.