This is the application for a certified copy of a fetal death certificate issued by the Maryland Department of Health, Division of Vital Records. A copy of a fetal death record may be issued only to a parent named on the certificate, to a representative with a notarized letter from a parent, or to a person with a court order. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form and the ordering information are published by the agency at health.maryland.gov/vsa.
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What is Application for Certified Copy of Maryland Fetal Death Record?
The Application for Certified Copy of Maryland Fetal Death Record is the Maryland Department of Health, Division of Vital Records form used to ask for a copy of a Maryland fetal death certificate. It is a request for a copy, not the certificate itself.
The application collects three kinds of information. The first is about you: your name, current address, daytime phone number, e-mail address and your relationship to the person named on the certificate. The second identifies the record: name at delivery, date of delivery (month/day/year), sex, place of delivery (county or Baltimore City), hospital, certificate number if known, the mother's full maiden name and the father's full name. The third is the order: the number of certificates requested and the fee per copy.
By signing, the requester states that he or she is the person represented and affirms that the information is complete and accurate, subject to the criminal penalties set out at Maryland Code Annotated, Health-General Section 4-227.
The agency publishes this form next to a separate Death Certificate application (with a bilingual English/Spanish version) on its death-records page. This form is only for fetal death records. A block marked "For Issuing Office Only" is reserved for the Division.
Who needs to file Application for Certified Copy of Maryland Fetal Death Record?
The form states who may receive a copy of a fetal death record. Only these people can use it successfully:
- A parent named on the certificate.
- A representative who attaches a notarized letter signed by a parent granting permission to obtain the certificate.
- An individual who has a court order directing that the certificate be issued.
The application asks for your relationship to the person named on the certificate, so it must show which of these you are. The person requesting the record should also submit a legible copy of valid government-issued photo ID with the application.
Anyone who is not a named parent, a representative with a notarized parent's letter, or the holder of a court order is outside the form's stated rule. Funeral facilities are mentioned separately by the agency: they may keep requesting certificates through the funeral facility portal or by mail.
Applicants who are the child of a current or former armed forces member, or who are requesting on that member's behalf, should note the no-fee rule explained under How to submit.
When to file Application for Certified Copy of Maryland Fetal Death Record
You complete this application whenever you need a certified copy of a Maryland fetal death record; the form prints no deadline and no validity period. Gather your photo ID, any permission letter or court order, and payment before you send it, because the Division of Vital Records works from what you submit with the application. Expedited shipping is not available when you order by mail, so allow for ordinary mail time in both directions, since you must include a self-addressed, stamped envelope for the return.
Documents you need
- A legible copy of valid government-issued photo ID, such as a state driver's license or non-driver photo ID showing your current address, or a passport.
- If you have no government-issued photo ID: the signed statement printed on the form plus photocopies of two documents showing your name and current address. Accepted types: utility bill, car registration form, pay stub, bank statement, income tax return/W-2 copy, government agency letter requesting a vital record, or lease/rental agreement.
- A notarized letter signed by a parent granting permission, if you are a representative and not a parent named on the certificate.
- A court order directing that the certificate be issued, if you request on that basis.
- Proof of service in the armed forces, only if you claim the no-fee rule for a child of a current or former armed forces member.
- A self-addressed, stamped envelope, when ordering by mail.
- A check or money order payable to the DIVISION OF VITAL RECORDS for the fee, when ordering by mail; no cash. A check must come with a copy of your photo ID listing your current address, or other acceptable ID.
How to fill out Application for Certified Copy of Maryland Fetal Death Record
Sign and date the application
Sign on the line for the person making the request and enter the Date of Application. By signing you affirm that you are who you say you are and that the information is complete and accurate.
Print your name and address
Under "PRINT or TYPE your name & CURRENT address," enter your Name, Address, City, State and Zip.
Add contact details and relationship
Enter your daytime phone number and e-mail address. In the relationship box, state your relationship to the person named on the certificate.
Complete the photo ID section
Attach a legible copy of valid government-issued photo ID. Only if you have none, read and sign the statement and attach two photocopied documents with your name and current address.
Enter the delivery details
Write the Name at Delivery and the Date of Delivery as Month/Day/Year, and mark Male or Female for Sex.
Identify place of delivery
Enter the Place of Delivery (county or Baltimore City), the Hospital and the Certificate No. if you know it.
Enter the parents' names
Write the Full Maiden Name of Mother and the Full Name of Father.
Complete the order information
Enter the number of certificates requested and the amount enclosed, using the fee per copy shown on the form. Note the armed forces no-fee rule if it applies.
Review, sign and download the PDF
Check names, dates and the place of delivery against your records, and make sure both signature lines are completed. Download or print the completed PDF from FillingPDF and assemble the package described under How to submit.
How to submit Application for Certified Copy of Maryland Fetal Death Record
You can order a copy by mail, in person or online.
- By mail: send the completed application, a legible copy of your ID, a self-addressed, stamped envelope, and a check or money order payable to the DIVISION OF VITAL RECORDS to: Division of Vital Records, P.O. Box 68760, Baltimore, Maryland 21215-0036. Do not send cash. A non-refundable fee applies to each copy; the form lists the current amount. If you pay by check, include a copy of your driver's license or other government-issued photo ID that lists your current address, or other acceptable ID. Expedited shipping is not available by mail.
- In person: the form says you may apply in person; see the Vital Statistics Administration website at www.health.maryland.gov/vsa for details.
- Online: the agency directs online orders to www.vitalchek.com, an independent company it has partnered with. VitalChek charges an additional fee and accepts major credit cards.
There is no fee for a copy for a child of a current or former armed forces member when the copy will be used for a claim for a dependent or beneficiary of the member; proof of service must be provided.
FillingPDF lets you fill out and download the PDF; submission follows the agency's channels above.
Common mistakes to avoid
- Requesting a copy when you are not a parent named on the certificate and have neither a notarized parent's letter nor a court order.
- Sending the application without a legible copy of valid government-issued photo ID, or with an ID that does not show your current address.
- Sending only one document, or originals, when you have no photo ID; the form requires two photocopied documents because they are not returned.
- Mailing cash; the form says to send a check or money order only.
- Making the check or money order payable to anyone other than the DIVISION OF VITAL RECORDS.
- Leaving out the self-addressed, stamped envelope when ordering by mail.
- Submitting the application unsigned, or without the date of application.
- Expecting expedited shipping on a mail order; the agency does not offer it by mail.
- Claiming the armed forces no-fee exception without proof of service.
Frequently asked questions
What is a fetal death certificate application in Maryland?
It is the Maryland Department of Health, Division of Vital Records form used to request a certified copy of a Maryland fetal death record. It does not create the certificate; it asks the Division to issue a copy of an existing record.
Who can get a copy of a fetal death certificate in Maryland?
A parent named on the certificate, a representative with a notarized letter signed by a parent granting permission, or an individual with a court order directing that the certificate be issued. The application asks for your relationship to the person named on it.
Can I fill out the fetal death certificate application online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF does not submit it: you mail it to the Division of Vital Records, apply in person, or follow the agency's online ordering route, and FillingPDF is not affiliated with the agency.
Where do I mail the Maryland fetal death record application?
Mail it to the Division of Vital Records, P.O. Box 68760, Baltimore, Maryland 21215-0036. Include the completed application, a legible copy of your ID, a self-addressed, stamped envelope, and a check or money order payable to the DIVISION OF VITAL RECORDS.
What ID do I need to request a fetal death record?
A legible copy of valid government-issued photo ID, such as a driver's license, non-driver photo ID or passport. Without one, sign the statement on the form and attach photocopies of two documents showing your name and current address, such as a utility bill or bank statement.
Is there a fee for a copy of a Maryland fetal death certificate?
Yes, a non-refundable fee applies to each copy, and the form lists the current amount. Mail orders require a check or money order, not cash. There is no fee for a child of a current or former armed forces member when the copy supports a claim for a dependent or beneficiary and proof of service is provided.
Can I order a fetal death certificate online in Maryland?
The agency directs online orders to VitalChek (www.vitalchek.com), an independent company it has partnered with. VitalChek charges an additional fee and accepts major credit cards. You can also apply by mail or in person.
Is expedited shipping available for a mail order?
No. The Division of Vital Records states that expedited shipping is not available when you order by mail. Include a self-addressed, stamped envelope so the copy can be returned to you.
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