New Mexico Bureau of Vital Records
Vital Records Website
1-833-796-8773
Please mail application to:
New Mexico Vital Records and Health Statistics
2554 Camino Entrada
Post Office Box 26110
Santa Fe, NM 87502
BIRTH RECORD
SEARCH APPLICATION
The average application processing time is 6‐12 weeks. Processing time is subject to change, depending on volume of incoming applications
and information needed to process the request.
Warning: A false or fraudulent application submitted into Vital Records is a criminal offense and punishable by fine and/or imprisonment.
New Mexico Bureau of Vital Records and Health Statistics requires a photocopy of your government‐issued picture identification.
1. Applicant information: Name of individual requesting the vital record (Please complete legibly. Incomplete applications will be rejected).
Name of Applicant (Please use full name without initials/abbreviations) Name of Agency (if applicant is an organization)
Mailing Address (House number and street) (City, State and Zip Code)
Physical Address (House number and street) (City, State and Zip Code)
If no physical address due to homelessness, please check box: ☐
Telephone Number
( )
Alternate/Message Telephone Number
( )
Email Address
Only immediate family is eligible to obtain a vital record. Immediate family is defined as the registrant’s mother, father, sibling, child, grandchild, current
spouse, maternal grandparent and paternal grandparent. The father and paternal grandparent are only eligible if the father is listed on the birth record.
Non‐immediate family must provide tangible proof of legal interest to obtain the requested record.
2. Applicant’s Relationship: Please indicate your relationship to the person on the certificate.
☐ Self
☐ Mother
☐ Father
☐ Sibling
☐ Child
☐ Grandchild
☐ Current Spouse
☐ Maternal Grandparent
☐ Paternal Grandparent
☐ Other (Please Specify):
3. Registrant Information (mandatory for search)
Registrant’s Full Name at Birth (Please print first, middle, and last name of person on certificate. No abbreviations/initials)
Gender
Date of Birth: Month/Day/Year
Place of Birth: City/County
New Mexico
Mother’s Full Maiden Name
Father’s Name
Please make payment payable to: New Mexico Vital Records. The fee is for the search of the record and will include one certified copy of the record, if
available. The search fee is non‐refundable if the record is not filed.
The birth certificate fee is waived for homeless individuals. Please complete a “Self‐Attestation Form” to submit with the application to notify Vital Records
of the homeless living situation.
4.Payment and Quantity 5. Purpose of Request (Please check the reason(s) for use):
Signature of Applicant Date of Application
Quantity of Birth Certificates @ $10:
(fee waived if homeless)
Quantity Chargeable Amendment @$10:
TOTAL Fees Enclosed:
$
☐ Check ☐ Money Order ☐ Cash
Check/Money Order Number:
☐ Amendment to Vital Record ☐ Estate/Probate ☐ Employment
☐ Genealogy
☐ Identification
☐ Insurance
☐ Medical
☐ Passport/Visa
☐ Sports
☐ Tax Purpose
☐ Retirement
☐ School
☐ Social Security
☐ Other (state other
reason):
Identification Type:
State Identification Issued:
Identification Number:
ID Expiration Date:
This section for Vital Records Use Only
Order Number:
SP#:
Clerk:
Date:
