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Information To Apply For Birth Certificate


When applying for a certified copy of a birth record, applicant MUST HAVE valid photo identification.  Please include the following information in your request:

1. NAME AT BIRTH:  First, Middle, Last                                       

2. DATE OF BIRTH:   Month, Day, Year

3. MOTHER'S MAIDEN NAME: First, Middle, Last                    

4. FATHER'S NAME:  First, Middle, Last

5. IS THE INDIVIDUAL NAMED ON LINE 1 ADOPTED: Yes or No

6. WHAT IS YOUR RELATIONSHIP TO THE PERSON ON LINE 1?

7. PRINT APPLICANT NAME:

8. APPLICANT'S PRESENT ADDRESS:                                       TELEPHONE #:

9. CITY & STATE:                                                                                         ZIP CODE:

10. APPLICANT'S SIGNATURE: 

Birth certificates are issued ONLY to the individual, the parent(s) named on the record, any heir, legal guardian, or a court of competent jurisdiction.  Legal representatives must state whom they are representing and have verification thereof.

FEE:  $20.00 for one certified copy and $10.00 for each additional obtained at the same time.

IF REQUEST IS BY MAIL, please send MONEY ORDER for the amount, a copy of the applicant's driver's license and enclose a stamped self-addressed envelope. Questions, please call (313) 386-1800 Ext. 1247.

MAIL ALL REQUESTS TO:  City of Lincoln Park
                                                   City Clerk's Office
                                                   1355 Southfield Rd.
                                                   Lincoln Park, MI 48146