Transcription of APPLICATION FOR CERTIFIED COPY OF BIRTH/DEATH …
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Example: tourism industry
APPLICATION FOR CERTIFIED COPY OF BIRTH/DEATH …
APPLICATION FOR CERTIFIED COPY OF BIRTH/DEATH CERTIFICATEB irth CertificateBirth certificate + birth Card (sold as pair only)Death CertificateNumber of Copies Requested:Number of Pairs Requested:Number of Copies Requested:$ each$ $ eachSUBTOTALMail orders add $ state charge per transaction (no coins)TOTAL FEES DUE Record InformationName at birth /DeathFirstMiddle Last Date of birth /DeathSexFather's Name Last Middle FirstCity of birth /DeathParish of birth /DeathMaidenMiddle Mother's Full Maiden Name before MarriageFirstRelationship to Person Named on the certificate (must submit photo ID)SelfMotherFatherChildGrandparentGrand childSisterBrotherCurrent SpouseLegal Guardian (with judgement of custody)Other (specify):Applicant InformationFirst NameLast NameResidence AddressCityStateZIP CodeDay PhoneEmailI am aware that any person who willfully and knowingly makes any false statement on an APPLICATION for a CERTIFIED copy of a vital record is subject upon conviction to a fine of not more than $10,000 or imprisonment of not more than five years, or both.
APPLICATION FOR CERTIFIED COPY OF BIRTH/DEATH CERTIFICATE. Birth Certificate. Birth Certificate + Birth Card (sold as pair only) Death Certificate. Number of Copies Requested: Number of Pairs Requested: Number of Copies Requested: $15.00. each. $24.00 $7.00. each. SUBTOTAL Mail orders add . $0.50 . state charge per transaction (no coins) …
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