Utah Birth Certificate Fee Waiver for Homeless
Fact Sheet August 2021
Office of Vital Records and Statistics
(801) 538-6105 / [email protected]
Introduction
During the 2018 General Legislative Session, Utah lawmakers approved SB 196: Homeless
Identification Documents. Senate Bill 196 amends Utah Code 26-2-12.6 which requires that
state and local vital records offices in Utah waive the $22 initial birth certificate fee for homeless
individuals if certain criteria are met. The Utah Department of Health, Office of Vital Records
and Statistics (OVRS) and local health departments will begin processing requests for fee
waivers on Tuesday, May 8, 2018. Answers to frequently asked questions about the fee waiver
are provided below.
1. Who is eligible to apply for a birth certificate fee waiver?
An individual is eligible to apply for the fee waiver if they are homeless as defined in Utah
Code 26- 18-411, Utah Code 35A-5-302, or if they are an individual whose primary
nighttime residence is a location that is not designed for or ordinarily used as a sleeping
accommodation for an individual. Utah Code 26-18-411 defines a homeless person as an
individual who is chronically homeless and it includes someone who was chronically
homeless and is currently living in supported housing for the chronically homeless. Utah
Code 35A-5-302 defines a homeless person as an individual whose primary nighttime
residence is a permanent housing, permanent supportive, or transitional facility.
To be eligible for the waiver, a homeless individual must submit to the vital records office a
“Verification of Homeless Status to Waive Fee for Utah Birth Certificate or Identification
Card” form. A representative of an
approved Homeless Service Provider facility or agency
verifies to the vital records office that an applicant qualifies for the fee waiver.
2. How can a homeless individual obtain a free birth certificate?
There are 3 ways that a homeless individual can order a free birth certificate: online, by
mail, or in- person at a local vital records office. Instructions for each method of ordering are
provided below:
a. Online: A homeless individual must have an approved facility or agency assisting
them that has a subscriber account set up with SILVER, Utah’s web-based system
for ordering of birth certificates. The following steps must be taken in order to submit
an order online:
1. A representative of the facility or agency with a SILVER subscriber
account submits the request online at silver.health.utah.gov
and records
the SILVER order number provided.
Certificate or Identification Card” form is scanned
3. Acceptable identification documents of the homeless individual are
scanned
4. Email form and ID to [email protected]
with the SILVER order number
identified in the subject of the email.
5. If all application requirements are met, a birth certificate will be mailed
within two weeks to the mailing address provided online.
b. Mail: The following documents must be mailed to the Office Of Vital Records and
Statistics for a homeless individual to order a free birth certificate by mail. If all
application requirements are met, a birth certificate will be mailed within 2 weeks to
the mailing address provided in the application.
1. A birth certificate application available from vitalrecords.utah.gov.
2. Acceptable identification of the homeless individual
3. A copy of the “Verification of Homeless Status to Waive Fee for Utah
Birth Certificate or Identification Card” form.
c. In-Person: A homeless individual can order a free birth certificate in-person by visiting
any local vital records office located in Utah. A list of locations of vital records offices
can be found at
https://vitalrecords.utah.gov/utah-health-districts. Bring the following
documents:
1. A birth certificate application available from vitalrecords.utah.gov.
2. Acceptable identification of the homeless individual
3. A copy of the “Verification of Homeless Status to Waive Fee for Utah
Birth Certificate or Identification Card” form.
3. What Homeless Service provider agencies are approved to verify homeless status?
A representative of an approved Homeless Service Provider facility or agency must verify
to the vital records office that an applicant qualifies for the fee waiver.
Click here for the
approved provider list.
4.
How can a Homeless Services facility or agency get on the approved list?
5.
What is the OVRS mailing address?
Utah Department of Health, Office of Vital Records and Statistics, PO Box 141012, Salt
Lake City, UT 84114-1012
6. What forms of identification must be submitted to a vital records office by
individuals requesting free birth certificates?
Individuals requesting birth certificates must submit acceptable identification in order to
prove that they are entitled to the birth certificate that they have requested. Acceptable
identification includes one primary form of identification or at least two secondary forms of
identification.
Primary forms of identification include a government issued driver’s license or government
issued photo identification. Secondary forms of identification include a social security card
and a court order. A complete list of acceptable primary and second forms of
identification can be found at
https://vitalrecords.health.utah.gov/wp-content/uploads/ID-
list.pdf
7. To order birth certificates online, how can a facility or agency set up an
organization subscriber account in SILVER?
To set up an organization subscriber account for your facility or agency, visit
https://secure.utah.gov/vitalrecords/organizations.html
.
8. Where can an individual born outside of Utah obtain a copy of their birth certificate?
The Utah Department of Health only has birth certificates for individuals born in Utah. If
where you were born.
9. Do separate fee waiver forms need to be completed to request fee waivers for
multiple members of the same family?
Yes. It is necessary to complete a separate fee waiver form for each individual.
Applicant Name
Date of Birth
ID Card or Driver License Number if Available
Facility or Agency Name
Street Address
Mailing Address (optional)
Print Name Title
Signature Date
Email Phone
Verification of Homeless Status to Waive Fee
Questions about ordering a birth certificate can be directed to the Utah Department of Health, Office of Vital Records and
Statistics at (801) 538-6105 or v[email protected]. Questions about ordering an identification card can be directed to the
Utah Department of Public Safety, Driver License Division at (801) 965-4437.
IMPORTANT INFORMATION: This verification form must be completed by a representative of the Department of
Workforce Services or a homeless shelter or a permanent housing, permanent supportive housing, or transitional housing
facility (See Utah Code 26-2-12.6 and 53-3-105). To obtain a free Utah birth certificate, this form must be submitted with
a completed birth certificate application to the Utah Department of Health, Office of Vital Records and Statistics or a local
health department vital records office. To obtain a free identification card, this form must be submitted with a
completed identification card application to the Utah Department of Public Safety, Driver License Division. This form can
only be used for the purpose of waiving birth certificate and identification card application fees as authorized by Senate
Bill 196 passed in the 2018 General Legislative Session and does not waive other application requirements. This
verification is good for 60 days from the date it is verified by the facility or agency representative.
Section 1 APPLICANT INFORMATION
Section 2 FACILITY OR AGENCY INFORMATION
Section 3 FACILITY OR AGENCY VERIFICATION
I certify that I am a representative of the facility or agency named in Section 2 and that the applicant named in Section 1
is homeless as defined by Utah Code 26-18-411, Utah Code 35a-5-302, or is an individual whose primary nighttime
residence is a location that is not designed for or ordinarily used as a sleeping accommodation for an individual.
for Utah Birth Certificate or Identification Card
Applicant's primary night time
residence is a:
Permanent Housing Facility
Permanent Supportive Housing Facility
Transitional Housing Facility
Homeless Shelter
Location not designed for or ordinarily used as a
sleeping accomodation for an individual
For Office Use Only
Birth Cert _______
ID Card__________
Birth Records are available from 1905 - present.
Certificates may be ordered online at vitalrecords.utah.gov.
Please read this application carefully. It is a criminal violation to make false
statements on this application or to fraudulently obtain a vital records certificate.
All fees paid are non-refundable. If required information is missing from this
application, applicant will have 90 days to provide missing information.
[ ] This application is fully completed.
[ ] Payment is ready // Mail: Check or Money Order to 'Vital Records' is enclosed
[ ] My ID is ready. (See reverse for ID list) // Mail: Copy of ID enclosed
FULL NAME FOR CERTIFICATE ________________________________________________________________________
BIRTH DATE ____________________ BIRTH CITY AND COUNTY ____________________________________________
HOSPITAL OR PLACE OF BIRTH _______________________________________________________________________
PARENT 1 FULL NAME ____________________________________________ BIRTH DATE _____________________
PARENT 2 FULL NAME ____________________________________________ BIRTH DATE _____________________
Relationship to certificate holder: [ ] Self [ ] Parent [ ] Sibling [ ] Spouse [ ] Child [ ] Grandparent [ ] Grandchild
[ ] Other (requires documentary proof of relationship or legal need) Specify: ___________________________________________________
PRINTED NAME _______________________________________________________ PHONE __________________________
ADDRESS ___________________________________________________________________________________________
EMAIL ADDRESS _____________________________________________________________________________________
NUMBER OF CERTIFICATES 1 Search (non-refundable) includes 1 certified copy $22 +
Additional certified copies ($10 each) =
TOTAL FEE
SIGNATURE ___________________________________________________________ DATE ___________________________
ID # ______________________________ ID Exp __________ Request # ____________________________
Paid: Check Money Order Cash Credit Card Account Clerk Initials ________
MAILING ADDRESS: PO Box 141012 ◦ SLC, UT 84114-1012 ◦ PHYSICAL ADDRESS: 288 N 1460 W, SLC
801-538-6105 ◦ Fax 801-538-7012 ◦ [email protected] ◦ vitalrecords.utah.gov ◦ UDOH-OVRS-104 April 2021
OFFICE USE ONLY
BIRTH CERTIFICATE
APPLICATION
IDENTIFYING INFORMATION
APPLICANT
GENERAL INFORMATION
CHECKLIST
Identification is required for all non-public Vital Records.
Mailed requests must include an enlarged and easily identifiable photocopy of your identification from the list below or
your application will be returned.
If using a form of identification from the “Primary” column, one form of identification is required.
If using a form of identification from the “Secondary” column, two forms of identification are required.
Primary
(Need 1)
Government Issued Photo Drivers License Work Identification/Paycheck/W-2
Government Issued Photo Identification School, University or College Identification Card
Government Issued Work Identification Voter Registration Card
Employment Card Social Security Card
U.S. Military Identification Card U.S. Military Separation/DD-214
Tribal Identification Card Motor Vehicle Registration/Title
Pilot License Marriage License (not issued by Utah State Vital Records)
Alien Registration Card Court Order or Court Documents
Permanent Resident Card Jail/Prison Documents
Temporary Resident Card Probation Documents
U.S. Passport Property Tax Receipt
Foreign Passport Veterans Universal Access Identification Card
U.S. Certification of Naturalization Selective Service Card
Certificate of U.S. Citizenship Hunting/Fishing License
U.S. Citizen Identification Card Insurance Card or Documents
Matricula Consular Card Utility Bill
Concealed Weapon Permit Business License
Mexican Voter Registration Card Professional License
Jail/Prison Release Form (with picture)
· Novelty Identification Card
· Driving Privilege Card
who can provide appropriate identification request the certificate. Proof of relationship may be required.
ACCEPTABLE IDENTIFICATION LIST TO OBTAIN VITAL RECORDS
ID MUST BE CURRENT
We Cannot Accept:
If you cannot provide acceptable identification you may have a spouse, parent, grandparent, sibling, or adult child
Secondary
(Need 2)
