Name of the Organization : Kansas Department of Health and Environment
Type of Facility : How to File a Delayed Certificate of Birth
State : Kansas
Country : United States of America
Website : https://www.kdhe.ks.gov/
Application Form : https://www.statusin.org/uploads/24275-delayedbirth.pdf
How to File a Delayed Certificate of Birth :
** The enclosed Delayed Certificate of Birth form is used to record a birth that occurred in Kansas and that for some reason has not been filed with the Office of Vital Statistics.
Related : Kansas Department of Health Ordering Birth Certificates : www.statusin.org/8027.html
** If you are now 65 (or older) and are required to submit proof of age to qualify for retirement benefits, we recommend that you contact your –
** Local Social Security office,
** Railroad Retirement Board, or
** Company that may be providing your retirement benefits.
** Any of the above offices can advise you of their proof of age requirements. You may not be required to provide a delayed birth record.
** However, if you do need to obtain a Delayed Certificate of Birth, please follow the instructions below.
Requirements and Instructions :
** Please follow these instructions carefully – help us give you the best service in the shortest amount of time.
** Complete the top half of the Delayed Certificate of Birth in black ink or use a typewriter.
** Take the form to a notary public and sign your present legal name in the notary public’s presence on the Signature of Registrant line.
Note :
** If you are under 18 years of age, a parent must sign the notarized statement.
** The notary will then sign the certificate, indicate the commission expiration date, and apply the notary seal.
** This procedure will represent your sworn statement that the facts are true to the best of your knowledge.
** Do not write anything anywhere else on the Delayed Certificate of Birth.
** Obtain two documents that state your correct age or birth date.
** These documents must be at least five years old (they must have a date on them that is more than five years prior to the current date).
** At least one document must state your birthplace as Kansas and one document must include the name of at least one parent.
** Obtain two affidavits (use the reverse side of the Delayed Certificate of Birth) from two persons at least five years older than you who have actual knowledge of the date and place of your birth.
** Affidavits may be provided by the attending physician, midwife, parent(s), or older relative(s).
** Affidavits must be signed in the presence of a notary public. If you are unable to get one or both affidavits, substitute with additional documents (described in 4. above).
When you have the :
** Completed and notarized Delayed Certificate of Birth,
** Two documents (at least five years old) proving your age, birthplace, and parental information,
Affidavits :(or further documentation)
** Then you must submit the original documents or certified copies of the original documents to the Office of Vital Statistics.
** Uncertified photocopies are not acceptable.
** All documents and certified copies of documents will be returned with exception of the affidavits.
Contact Address :
Office of Vital Statistics
1000 SW Jackson Street, Ste 120
Topeka, Kansas 66612-2221
** There is a $20.00 filing fee that you must send with the documentation mentioned in 6 above.
** There is also a charge of $15.00 for a certified copy of your Delayed Certificate of Birth.
** If you have already submitted the certified copy fee, you do not need to send it again.
** You can send a copy of the receipt instead. (All fees expire 12 months from date paid.)