Order Connecticut | USVitalRecords.org

Connecticut Order Form

Birth Certificates are available for order from this website for events that occurred within the State of Connecticut. Birth records are not available until 90 days after the date of the event.

ID Requirements must be met before certificate is issued. You will receive an email with instructions on how to send your ID within one week of submitting this application.

Items with an * asterisk are required fields.

Information About the Certificate

City/County of : Please select the exact city and county of birth for the subject of the certificate.

City of Birth for the Subject

City is required

County of Birth for the Subject

County is required

Date of Birth: The exact date of birth of the person listed on the certificate.

Subject's Date of Birth (MM-DD-YYYY)

Subject Date of Birth is required

Click the MM-DD-YYYY field to open the calendar. Click on THE YEAR to type the correct year. Use the arrows to navigate to the month and then select the day.

Year of Birth Restriction: For the selected county we can only accept orders for births that occurred in the year 1906 or later.

Information About the Requestor

IMPORTANT: The requestor is the person ordering the certificate, not the person named on the certificate. If you are ordering your own certificate, you are both the requestor and the subject. The name of the credit card holder must be the same as the requestor.

First Name of Requestor

First Name is required

Middle Name of Requestor

Current Last Name of Requestor

Last Name is required

Suffix

Date of Birth & Social Security Number of the Requestor: This is an additional safeguard to protect your identity and the security of the requested certificate.

Date of Birth

Valid Date of Birth required

Important: Valid SSN only, no ITINs or temporary SSNs permitted.

Social Security Number

Valid SSN is required

Reason for Request

Request reason required

Information: If you are not named on the record you may be required to provide proof of Relationship, Entitlement, and/or Court Documents.

Important: The relationship selected must match your relationship to the subject exactly

Relationship To Subject

Relationship required

Information About the Subject of the Certificate

ADOPTED? Please visit our FAQ section for important information.

Name of Subject: The name exactly as it appears on the certificate.

First Name of Subject

Subject First Name is required

Middle Name of Subject

Subject Middle Name is required

Current Last Name of Subject

Subject Last Name is required

Suffix

Gender

Subject Gender is required

Maiden Last Name of Subject

Subject Maiden Name is required

Is subject still living?

Subject Status is required

Name of Mother: Please enter both the current last name and the maiden last name of the mother.

First Name of Mother

Mother's First Name is required

Middle Name of Mother

Current Last Name of Mother

Mother's Last Name is required

Maiden Last Name of Mother

Mother's Maiden Name is required

Name of Father: Select "unknown" If the father is unknown or was not listed on the birth certificate.

Father's Status

Father's Status is required. If relationship is Father, Unknown is not a valid selection.

First Name of Father

Father's First Name is required

Middle Name of Father

Last Name of Father

Father's Last Name is required

Suffix

Address & Contact Information

Shipping & Billing Address

Shipping & Billing Address Type

Invalid Billing Address Type

Requirements: The Billing Address Name must match the Requestor Name

First Name

First Name is required

Last Name

Last Name is required

Address Line 1

Billing Address Line 1 is required

Unable to ship to PO Box if UPS is selected as a shipping option

Address Line 2

Unable to ship to PO Box if UPS is selected as a shipping option

City

Invalid City selection

State

Invalid State selection

International State/Province

International State/Province is required

APO/FPO

Invalid APO/FPO selection

Zip/Postal Code

Zip/Postal Code is required

Country

Invalid Country

Telephone & Email Address of the Requestor: ID requirements and other important information will be emailed to you. An incorrect email address will result in delays.

Daytime Phone Number

Invalid phone number

Alternate Phone Number

Email Address

Email Address is required

Confirm Email Address

Confirmation Email Address is required and must match Email Address

Certified Copy of Connecticut

Number of Copies

$35 OFF each additional official copy

Number of Copies is required

Qualifying Review

Processing Service is required

Important: Does not include ID verification and delivery times.

Processing and Delivery

Processing and Delivery is required

Important: UPS to Alaska, Hawaii or Puerto Rico is up to $27.50. UPS Canada/Mexico is up to $28.00. UPS to all international locations is up to $49.50. Delivery method and price are subject to change based on delivery location

Regular mail delivery is available, however, we recommend you choose a more secure shipping method that provides faster delivery and tracking of your order.

Connecticut State & Agency Fee

$42.95 per certificate ($30.00 each additional certificate)

Important: State and Agency Fees are subject to change. Delivery Time Frames are not guaranteed and delivery to remote areas may take longer

Credit Card Details

Credit Card Number

Credit Card Number is required

Credit Card Expiry Date (MM/YY)

Credit Card Expiration is required

Credit Card Security Code

Credit Card Security Code is required. For American Express cards, this is a 4-digit code found on the front of the card.

Important: This is a 3-digit code on the back for Visa, Mastercard, and Discover, and a 4-digit code on the front for American Express cards.

Order Summary

Connecticut

Qty: Not specified

Online Processing Fee:

Not specified

Qualifying Review:

Not specified

American Express/Discover Discount

Not specified

Connecticut State & Agency Fee:

Not specified

Shipping Fee:

Not specified

Total:

Not specified

IMPORTANT: You will be charged $(not specified) when you submit your order and the remainder will be charged when the order is processed by the state issuing agency.

IMPORTANT: The total price will be calculated and shown once all required fields on this order form have been completed.

Verify Order

1. I understand US Vital Records (USVR) offers professional advice and provides support to help eliminate errors when applying for vital certificates. USVR assists in verifying that applications are accurate to avoid delays in processing. USVR is not operated, licensed, or affiliated with any government agency.

2. I understand I will receive an email from the relevant government agency with instructions on how to send a copy of my government issued picture ID for verification.

3. I accept the Terms of Service, including the refund and cancellation policies.

Type your full name in the field below. Typing your full name constitutes a signature and an agreement that you have read and agreed to all the provisions above. It additionally affirms that all information provided on this order form is complete and accurate and that you are an authorized individual to obtain the requested vital certificate.

Type your full name in the field below to submit your order.

Signature is required

Possible Issues Detected

Hi there! You are seeing this message because our system detected one or more potential issues with your submission. Please review each issue below and make any necessary corrections. Once you are satisfied with your submission, you may continue by submitting the form again.

Mother maiden name is the same as father's last name. If this is correct, then please ignore this warning.

The Subject's maiden name is different than their last name. If this is correct, then please ignore this warning.

The Subject's maiden name is different than either parent's last name. If this is correct, then please ignore this warning.

Mother maiden name is the same as last name. If this is correct, then please ignore this warning.

Before submitting your order, please take a moment to review your information.
Incorrect information provided will lead to delays and could possibly cancel your order.

Connecticut Order Form

Possible Issues Detected

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