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PHOTO IDENTIFICATION REQUIRED - Mississippi
msdh.ms.govMississippi State Department of Health Page 1 of 2 Form No. 522 Revised 10/2021 . APPLICATION FOR CERTIFIED MISSISSIPPI BIRTH CERTIFICATE . Mississippi State Department of Health . Vital Records . Post Office Box 1700, Jackson, Mississippi 39215-1700 . FULL NAME ON BIRTH RECORD FIRST MIDDLE LAST HAS NAME CHANGED ...
APPLICATION FOR CERTIFIED MISSISSIPPI DEATH CERTIFICATE
msdh.ms.govThe $17.00 fee entitles the applicant to one certified copy of the death record on file (November 1, 1912, to present) or if the record is not found, a “Not on File” $17.00 X 1 = $17.00