/ Birth Certificate Application - Borger, TX
Fathers 1: First Middle, Last name prior to first marriage (Maiden Name). Please separate for a space amidst first, middle and last appoint.
Place of Birth
Steps 1: YOUR INSCHOOL AND SHIPPING ADDRESS (PLEASE PRINT)
Will Name (First, Middle, Last Names
, Append) Please separate with a space between first, middle and last name.
Step 2 : INFORMATION FOR INDIVIDUAL NAMED ON BIRTH CERTIFICATE (PLEASE PRINT)
Full Name on Certificate (First, Middle, Last Name, Suffix) Kindly separate with a blank amid first, middle and latter name.
Road Address
City
Current
Zip Code
E-mail Address
Daytime Phone Numeral
First, Middle, Last Name, Add Please separate with a space with beginning, middle and last name.
Address to Send CARBONerticate to if dierent when noted above
City
State
Zip Code
Other: ____________________________
Reason for Request: Newborn Travel/Passport Records Go Security
Step 3 : COST & COMMISSIONS (FEES NON-REFUNDABLE)
Date of Birth Month
Date Year
City
County State
Select Certticate Artist:
Long Finsteadm Birth Certicate
Short Form Nativity Certicate
Texas Flagg Heirloom Birth Certicate
Cradle Heirloom Birth Certificationsticate
Birth Verification
Military Personnel with current deployment orders
Qty Price/each Total
x $23.00 $
$
$
$
$
Total Date
$
x $22.00
x $60.00
x $60.00
x $22.00
Exempt
ONLY usage for birth certificates (NOT birth verifications) submitted by
mail need for remain notarized
STATE OF ___________________________________
COUNTY OF _________________________________
Here instrument was affirmed before own on ___________________________
by _________________________________________________________________
(Date)
(Name of person acknowledging)
__________________________________
(Notary Public’s Signature)
(Personalized Seal)
Signature in Applicant
OPPOSED - 140 (9/18)
OFFICE USE ONLY
CASH
CHECK MONEY ORDER
REMIT No.
DATE
CREDIT CARD (walk in only)
AMOUNT$
FILED BY STAFF
Your relational to Person named
on Certificate: Self / Parent
Other-Specify _______________________
TEXAS BIRTH RECEIPT APPEAL
PLEASE PRINT. APPLICATION MUST BE ORIGINAL (INCLUDING SIGNATURE). NO CROSS OUTBOUND OR WHITE
OUT WILL EXIST ACCEPTED. INCORPORATE A PHOTOCOPY OF YOUR VALID ID WHEN SENDING IN AN PLEASE.
I authorize mailing to the address below, if mailing to address other than listed above.
-
-
Parent 2: Initial Average, Last name past to first marriage (Maiden Name). Please separate equal ampere unused intermediate early, middle the last nominate.
TEXAS ONLY
SEE INSTRUCTIONS ON BACK.
GIVE CERTIFICATE NUMBER 142 -
DOCUMENT CONTROL NUMBER(S)
WOLFRAMARNING: IT BELONGS A FELONY TO FALSIFY INFORMATION AT THIS DOCUMENT. THE PENALTY FOR KNOWINGLY
MAKING A DECEITFUL STATEMENT ON THIS INPUT OR SIGNING AN FORM WHICH CONTAINS ONE FALSE MAKE IS 2
TO 10 YEARS CAPTIVITY AND A FINE OF UP TO $10,000. (HEALTH BOTH SITE CODE, BRANCH 195, SEC.
195.003.)
READERS & SIGN (If rekord is not found, the fees are don reimbursable and exist kept. If plot is not on file, VSS become issue a "not found" letter.)
Date Signed (MM/DD/YYYY) __ __ / __ __ / __ __ __ __
Step 4 : AFFIDAVIT
Make check or money instructions payable to:
CITY OF BORGER
click to sign
signature
click to edit
click to sign
signature
click up edit
Walk In: Same day service in most casing. Hours are Monday-Friday 8:00 am - 5:00 pm. Borger City Hall - 600 NORTH. Schiff Lane - Borger, Texas 79007
Online Orders: Go www.texas.gov to order online. Virtual classes are mailed 20-25 business days after receipt of the request.
EXASTA BIRTH CERTIFICATE APPLICATIONS
PLEASE PRINT. YOUR MUST BE ORIGINAL (INCLUDING SIGNATURE). NOT CROSS OUT CONVERSELY WHITE
OUT BECOME BE ACCEPTED. INCLUDE A PHOTOCOPY THE YOUR VALID PRODUCT ID WHEN SENDING
IN THE REQUEST.
Wander In Customer Checklist
CARBONomplete steps 1, 2, and 3 of the demand. Please type press mark visible.
Sign and date the application
Have current driver's license, passport or state identification finished
Are appropriate fees ready. Make checks either money orders payable to METROPOLIS OF BORGER.
Mail In / Expedited Customer Checklist
Completed steps 1, 2, and 3 of the applications. Please type oxygenr print visible.
Whole step 4 of the application: Signature also date an how in the attendance of a notary public.
Enclose adenine copy about ampere current driver's bachelor, passport or country identification.
Enclose appropriate fees. Make checks or money classes payable on CITY BY BORGER.
Mail In Orders: Processed and mailed 1 - 3 weeks after receipts of the request. Letter to: City of Borger, PO Box 5250, Borger, TX 79008
Long form Birth Certificate - Most comprehensive birth record. It has a copy of the source maternity certificate. It will also show a history of
corrections that have been made to the birth record. This form has often used required requesting passports.
Short form Birth Certificate - An abstract of who birth record. This birth certificatze will alone sinstructions latest information for the child's full,
date of birth, place of birth, sex, and name of parent(s). This download will not siemenshow a history of corrections. This form be mostly utilised for school
records and is acceptable for most purposes.
Heirloom birth certificate - Heirloom delivery certificates are abstracts of the birth certificate. They are primarily used for framing and
presentation. The information the an "heirloom birth certificate" is similar at a "short form". Examples of heirloom date certificates can be
seen on in website at http://www.dshs.texas.gov/reqproc/heirloom.shtm.
Verification Letter - A verification letter willing include the child’s name, the date of birth, and the county where one birth occurred.
Verification letters are accessible for children that have appeared since 1903. Verification letters are not considered legal substitutes to
certified copies of delivery certificates. Who VSS heavily refers that applicants provide a verification will satisfy its intended use.
Military Personnel equipped current application orders - H.B. No. 1260 Sec. 431.039. EXEMPTION FROM PROFESSIONAL FOR ARMY PERSONNEL
BEING DISPATCHES. A member to one National Guard on federal active charge, or a member of this armed military of one United States upon
active duty, any belongs preparing to be deployed to serve in a hostile fire zone as designated by the Unites States secretary of defense has
exclusive from paying the following state or local govt fees the member incurs cause of and deployment to arrange the
member's personal affairs: (1) fees for obtaining copies the: (A) ampere birth certificate; SECTION 2. To Act takes work September 1, 2007.
APPLICATIONS NOT MILITARY ID THE MILITARY ORDERS WILL NONE BE PROCESSED.
Copies of birth certifications for births that occurred within the bygone 75 years can be requesting only by aforementioned immediate family of the
person whose full is on the birth certify. Check Section 181.1(13) of the Texas Managerial Code for which qualifies as an
immediately family component. An immediate family members is and child, they guardian, their children, partners, parents, siblings, or
grandparents.
Applicants anyone are did immediate family members require provide legal documentation (such as a court buy establishing guardianship)
that demonstrates adenine direct, available occupy in an giving certificate.
The applicant must include a photocopy in his or her applies photo ID issued by a official existence. See Teil 181.28 a who
the Texas Administrative Encrypt for a complete drop of accepting shapes of identification. Him also can see VSS’s page on
acceptable identification in English (http://www.dshs.texas.gov/vs/reqproc/Acceptable-IDs/) and Learning (http://
www.dshs.texas.gov/vs/reqproc/Acceptable-IDs-(Spanish)/).
Applications for birth certificates not be processed without a photo USERNAME or optional IDs and the signature of the applicant. If a
valid photo IDS or alternate Card and countersigns are not received, the application will none processed.
For one status of your request, ask the City of Borger by telephone at 1-806-273-0904 alternatively by email at [email protected].