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Arkansas Birth Certificate Application PDF 2023
Arkansas Birth Certificate Application PDF 2023 : Only Arkansas births are recorded in this office. There are a limited number of birth records filed in this office prior to February 1, 1914. The fee is $12.00 for the first copy ordered and $10.00 for each additional copy of the same record. The fee must accompany the application. Send check or money order payable to the Arkansas Department of Health. DO NOT SEND CASH.
Of the total fee you send, $12.00 will be kept to cover search charges if no record of the birth is found. Only the names and dates listed will be searched for the $12.00 fee. Names and other dates submitted later will require an additional $12.00 non-refundable fee. Mail this application, a copy of your photo id and the money to the address above.
How much do Arkansas birth certificates cost?
The cost of a birth record is $12.00 for the first copy and $10.00 for each additional copy of the same record that is ordered at the same time. If you choose to order online through Vital Records, a $5.00 standard processing fee and a $1.85 non-refundable identity verification fee will be charged in addition to the cost of any expedited shipping options you select. If no record is found or no copy is made, state law requires that we keep $12.00 for a search fee. The processing fee for online orders is also non-refundable. However, you will receive a refund of any amount you paid apart from these fees.
How To Download Arkansas Birth Certificate Application PDF 2023
How can I obtain a Arkansas birth certificate?
Arkansas Birth Certificate Application PDF : Eligible individuals may order a birth certificate by any of the following methods:
- Online: You may order a copy of a birth record online in minutes through Vital Records. Multiple expedited shipping options are available through this service. Pay the service fee, certificate fee, and charges for any expedited shipping options by debit or credit card (Visa, Mastercard, Discover, or American Express). Requests typically take 7-14 business days from the date your order is approved plus additional shipping time.
- By Mail: You may order a certified copy of the birth record by mailing in a completed application (available here or from your local health unit) a check or money order made out to Arkansas Department of Health (no cash or temporary checks), and a copy or copies of acceptable ID to:
Arkansas Department of Health
Vital Records, Slot 44
4815 West Markham Street
Little Rock, AR 72205
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Please allow 10-14 days for processing, in addition to mail delivery time.
- Walk-in: You may order a certified copy of the birth record by coming into the Arkansas Department of Health’s vital records office. The office is located at 4815 West Markham St. Little Rock, AR 72205, across the street from War Memorial Stadium, and is open Monday through Friday, 8:00 A.M. until 4:30 P.M. The office is closed on state holidays. Most certificate requests can be fulfilled the same day for customers arriving by 4:00 P.M., provided they are eligible to receive the certificate requested and have all the required information, including acceptable ID (see above). However, same day service is not guaranteed for non-routine requests such as certificate corrections, court orders, paternity affidavits, and genealogical requests prior to 1935. Customers who arrive in the office after 4:00 P.M. may pick up their request the following day or may ask that it be mailed. Walk-in payment options are cash, credit or debit cards, or a check or money order made out to Arkansas Department of Health (no temporary checks are permitted).
- Telephone: You may order a copy of the birth record via telephone toll-free at (866) 209-9482. Multiple expedited shipping options are available through this service. Payment of service fee, certificate fee, and charges for any expedited shipping options may be made by debit or credit card (Visa, MasterCard, Discover, or American Express).
Who should I contact with additional questions about ordering a Arkansas birth certificate?
If you have questions on registering, amending, or obtaining copies of vital records, please contact the Arkansas Department of Health Vital Records Office at: [email protected]. Office hours are Monday through Friday, 8:00am to 4:30pm, with the exception of state holidays. If you are having technical difficulties, click here, and fill out the online form and submit.
How can I check on the status of my vital record order?
To obtain the status of an order you have submitted, use the “Check Order Status” service. Simply enter your confirmation number to view your status.
Change or Amend a Birth or Arkansas Death Certificate
Legal statutes permit the Arkansas Department of Health to amend certificates with appropriate documentation. For each action, the Arkansas Department of Health must use a specific procedure that is mandated by law. Therefore, each case must be reviewed by our staff individually to determine what documents or actions will be required to make the requested amendment.
Changes Requiring a Court Order
There are some actions that require a court order before the certificate can be changed. Examples of some of these are:
- The creation of a new birth certificate after a child has been adopted
- Adding a natural father to a birth certificate if the mother was married to another man
- Changing the father on a birth certificate
- Changes of surname
- Surrogate motherhood
If a court order is required, normally an attorney is needed for this type of action.
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Cost of Amendments – Arkansas Birth Certificate Application PDF
The legal fee for amending a birth or death certificate, with or without a court order, is $15.00. This is in addition to the certificate fee for any replacement certificates that are requested. Birth certificates cost $12.00 for the first copy and $10.00 each for additional copies ordered at the same time. Death certificates cost $10.00 for the first copy and $8.00 for additional copies ordered at the same time.
However, if any incorrect certificates are returned to the Arkansas Department of Health within one year of their issuance, they may be replaced without charging a certificate fee. The Arkansas Department of Health accepts cash, checks, money orders made out to Arkansas Department of Health, and all major credit cards, including American Express®, Discover®, MasterCard® or Visa®. Please do not send cash in the mail.
Contact Information – Arkansas Birth Certificate Application PDF
Please refer any questions regarding amendments to birth and death records to the Arkansas Department of Health at 501-682-1214 or [email protected]. Office hours are Monday through Friday, 8:00am to 4:30pm, with the exception of state holidays, when the office is closed. Please refer any questions regarding amendments to marriage and divorce records first to the County or Circuit Clerk’s office where the record was initially recorded.
Change Sex and Name on a Arkansas Birth Record
Required Documentation – Arkansas Birth Certificate Application PDF
A court order is required in order to change one’s sex and name on a birth certificate following a surgical procedure. Normally an attorney is needed for this type of action. Once a court order is obtained, the requestor of the amendment must provide a certified court order specifying to change the person’s name and stating that the sex is to be changed due to a surgical procedure.
(If the court order does not specify that a surgical procedure was performed, the requestor must also submit a letter from the doctor who performed the procedure, stating that it was done and written on that doctor’s official letterhead).
Submission Methods
Once these materials are submitted (along with appropriate payment) to the Arkansas Department of Health at 4815 West Markham, Slot 44, Little Rock, AR 72205, either by mail, in person, by phone (501-682-1214), by fax (501-661-2869), or by email ([email protected]), the amendment can be made without the need for any additional forms. Office hours are Monday through Friday, 8:00am to 4:30pm, with the exception of state holidays, when the office is closed.
Add or Remove Father’s Name from Birth Record
Add Father’s Name to a Birth Record – Arkansas Birth Certificate Application PDF
The procedure for adding a father’s name to a birth record varies depending on the parents’ marital status, both at the time of birth and at the time the amendment to the record is requested, as well as the current presence or absence of another name on record as the father.
If a different person’s name is currently on record as the father:
A court order will be required in order to make any changes to the record. Normally an attorney is needed for this type of action.
If the mother was married to another man during the child’s conception or birth:
A court order will be required in order to make any changes to the record. Normally an attorney is needed for this type of action. If the mother was married to another man during the child’s conception or birth and there is no father listed on the child’s certificate, a three-way paternity affidavit can be filled out. The mother and husband/ex-husband will sign the back of the form and the mother and biological father will sign the front of the form.
Both sides of this form must be notarized by a notary public. Parents can come in person to the Arkansas Department of Health at 4815 West Markham, Slot 44, Little Rock, AR 72205, or they submit a request that the form and instructions be mailed to them via phone (501-682-1214), fax (501-661-2869), or email ([email protected]).
Alternatively, they can obtain the form from any hospital’s medical records department and return it completed, along with payment, by mail to the Arkansas Department of Health at the address above. Office hours for the Arkansas Department of Health are Monday through Friday, 8:00am to 4:30pm, with the exception of state holidays, when the office is closed.
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If the mother and father were married to one another during the child’s conception or birth and no name is currently on record as the father:
An affidavit for correction will need to be signed by both parents. Please contact the Arkansas Department of Health at 4815 West Markham, Slot 44, Little Rock, AR 72205, either by mail, in person, by phone (501-682-1214), by fax (501-661-2869), or by email ([email protected]). Office hours for the Arkansas Department of Health are Monday through Friday, 8:00am to 4:30pm, with the exception of state holidays, when the office is closed.
If the mother and father were not married to one another during the child’s conception or birth and remain unmarried now:
An Acknowledgement of Paternity (PA) or affidavit for correction will need to be completed. Parents can come in person to the Arkansas Department of Health at 4815 West Markham, Slot 44, Little Rock, AR 72205, or they submit a request that the requisite forms and instructions be mailed to them via phone (501-682-1214), fax (501-661-2869), or email ([email protected]).
Alternatively, they can obtain the Acknowledgement of Paternity form from any hospital’s medical records department and return it completed, along with payment, by mail to the Arkansas Department of Health at the address above. Office hours for the Arkansas Department of Health are Monday through Friday, 8:00am to 4:30pm, with the exception of state holidays, when the office is closed.
If the mother and father were not married to one another during the child’s conception or birth and have since married:
Paperwork for a legitimation will need to be completed. Please click here to download the legitimation affidavit, along with full instructions on completing the legitimation process.
| Downloads |
| Legitimation Packet (Affidavit and Instructions) |
Remove Father’s Name from a Arkansas Birth Record
The procedure for removing a father’s name from a birth record requires a court order, unless it is done within sixty days of the date that the paternity affidavit naming that individual as the father was filled out. If a court order is required, an attorney is generally needed. However, if sixty days have not yet passed, a rescission form may be submitted by either signer of the original paternity affidavit.
The form must be filed with the Arkansas Department of Health at 4815 West Markham, Slot 44, Little Rock AR 72205 within sixty days of executing the acknowledgement of paternity or prior to the date that an administrative or judicial proceeding, including a proceeding to establish a support order, is held relating to the child and to which the person executing the voluntary acknowledgement is a party, whichever date occurs first. A copy should also be sent to the Office of Child Support Enforcement at P.O. Box 8133, Little Rock, AR 72203.