Form ADPH-HS 88 Application to Request a New Birth Certificate After Adoption - Alabama

Form ADPH-HS88 is a Alabama Department of Public Health form also known as the "Application To Request A New Birth Certificate After Adoption". The latest edition of the form was released in April 1, 2018 and is available for digital filing.

Download a PDF version of the Form ADPH-HS88 down below or find it on Alabama Department of Public Health Forms website.

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APPLICATION TO REQUEST A NEW BIRTH CERTIFICATE AFTER ADOPTION
When a child is adopted through an Alabama court, the court forwards the order of adoption and information showing the child’s new name
and the names of the new parents to the Center for Health Statistics in Alabama. Upon receipt of the information, the Center for Health
Statistics will do one of the following depending upon where the child was born:
IF THE ADOPTED CHILD WAS BORN IN ALABAMA:
The Center for Health Statistics will prepare a new birth certificate for the child showing the new names.
The fee to prepare the new certificate of birth after adoption is $25.00 which includes one certified copy of the new record.
Additional copies of the same record ordered at the same time are $6.00 each. There is an additional fee of $15.00 to expedite a
request.
To obtain a copy of the child’s new birth certificate, complete the application form below.
Valid identification must be submitted with all requests for a new Alabama birth certificate after adoption. See
identification requirements on the reverse side.
IF THE ADOPTED CHILD WAS BORN IN ANOTHER STATE:
The new birth certificate for the child must be prepared in the state where the child was born.
The fee for the Center for Health Statistics to forward the order of adoption to the child’s state of birth is $10.00.
Upon receipt of the fee, the Center for Health Statistics will forward the court order of adoption and the information showing the
new name to the appropriate vital records office in the state where the child was born.
You will need to contact the state of birth for a copy of the new certificate.
Make check or money order payable to the “State Board of Health.” Fees are non-refundable. Do not send cash. Complete the
application below and send with the required documents and appropriate fee to:
Center for Health Statistics
Adoption Specialist
P.O. Box 5625
Montgomery, AL 36103-5625
If this is an adult adoption or you have additional questions, call 334.206.2643. Please allow 2-4 weeks after the court action has been
completed before mailing your application, valid identification (if requesting an Alabama birth certificate) and fee.
IF THE CHILD WAS BORN IN A FOREIGN COUNTRY, DO NOT COMPLETE THIS FORM. Contact the Center for Health Statistics
at 334.206.2643 for additional information and appropriate forms.
FULL NAME OF CHILD BEFORE ADOPTION
(IF KNOWN)
FIRST
MIDDLE
LAST
FULL NAME OF CHILD AFTER ADOPTION
FIRST
MIDDLE
LAST
STATE OF BIRTH
COUNTY OF BIRTH
DATE OF BIRTH
SEX
FULL NAME BEFORE FIRST MARRIAGE OF
MOTHER/PARENT ON NEW BIRTH CERTIFICATE
FIRST
MIDDLE
LAST
FULL NAME BEFORE FIRST MARRIAGE OF
FATHER/PARENT ON NEW BIRTH CERTIFICATE
FIRST
MIDDLE
LAST
If Alabama Birth,
Amount
APPLICANT SECTION
Number of Copies
Enclosed
__________
$ __________
(THIS SECTION MUST BE COMPLETED)
Anyone falsely applying for a record is subject to a penalty upon conviction of up to three months in the county jail or a fine of
up to $500. Code of Ala. 1975, § 13A-10-109. By signing, you are certifying you have a legal right to the record requested.
YOUR SIGNATURE
DATE
PRINT YOUR NAME
DAYTIME PHONE (
)
ADDRESS
CITY
STATE
ZIP
ADPH-HS 88/REV. 04/2018
APPLICATION TO REQUEST A NEW BIRTH CERTIFICATE AFTER ADOPTION
When a child is adopted through an Alabama court, the court forwards the order of adoption and information showing the child’s new name
and the names of the new parents to the Center for Health Statistics in Alabama. Upon receipt of the information, the Center for Health
Statistics will do one of the following depending upon where the child was born:
IF THE ADOPTED CHILD WAS BORN IN ALABAMA:
The Center for Health Statistics will prepare a new birth certificate for the child showing the new names.
The fee to prepare the new certificate of birth after adoption is $25.00 which includes one certified copy of the new record.
Additional copies of the same record ordered at the same time are $6.00 each. There is an additional fee of $15.00 to expedite a
request.
To obtain a copy of the child’s new birth certificate, complete the application form below.
Valid identification must be submitted with all requests for a new Alabama birth certificate after adoption. See
identification requirements on the reverse side.
IF THE ADOPTED CHILD WAS BORN IN ANOTHER STATE:
The new birth certificate for the child must be prepared in the state where the child was born.
The fee for the Center for Health Statistics to forward the order of adoption to the child’s state of birth is $10.00.
Upon receipt of the fee, the Center for Health Statistics will forward the court order of adoption and the information showing the
new name to the appropriate vital records office in the state where the child was born.
You will need to contact the state of birth for a copy of the new certificate.
Make check or money order payable to the “State Board of Health.” Fees are non-refundable. Do not send cash. Complete the
application below and send with the required documents and appropriate fee to:
Center for Health Statistics
Adoption Specialist
P.O. Box 5625
Montgomery, AL 36103-5625
If this is an adult adoption or you have additional questions, call 334.206.2643. Please allow 2-4 weeks after the court action has been
completed before mailing your application, valid identification (if requesting an Alabama birth certificate) and fee.
IF THE CHILD WAS BORN IN A FOREIGN COUNTRY, DO NOT COMPLETE THIS FORM. Contact the Center for Health Statistics
at 334.206.2643 for additional information and appropriate forms.
FULL NAME OF CHILD BEFORE ADOPTION
(IF KNOWN)
FIRST
MIDDLE
LAST
FULL NAME OF CHILD AFTER ADOPTION
FIRST
MIDDLE
LAST
STATE OF BIRTH
COUNTY OF BIRTH
DATE OF BIRTH
SEX
FULL NAME BEFORE FIRST MARRIAGE OF
MOTHER/PARENT ON NEW BIRTH CERTIFICATE
FIRST
MIDDLE
LAST
FULL NAME BEFORE FIRST MARRIAGE OF
FATHER/PARENT ON NEW BIRTH CERTIFICATE
FIRST
MIDDLE
LAST
If Alabama Birth,
Amount
APPLICANT SECTION
Number of Copies
Enclosed
__________
$ __________
(THIS SECTION MUST BE COMPLETED)
Anyone falsely applying for a record is subject to a penalty upon conviction of up to three months in the county jail or a fine of
up to $500. Code of Ala. 1975, § 13A-10-109. By signing, you are certifying you have a legal right to the record requested.
YOUR SIGNATURE
DATE
PRINT YOUR NAME
DAYTIME PHONE (
)
ADDRESS
CITY
STATE
ZIP
ADPH-HS 88/REV. 04/2018
IDENTIFICATION REQUIREMENTS FOR RESTRICTED ALABAMA
VITAL RECORDS
Identification is required of any applicant requesting a restricted Alabama vital record
(birth certificate less than 125 years from the date of birth or death certificate less than 25 years
from the date of death). The applicant must submit a completed request and one form of
identification from the Primary ID list below. In the event the applicant is unable to provide
identification from the Primary ID list, he/she may provide two different forms of identification
from the Secondary ID list.
If the applicant designates another individual to pick up a restricted certificate on his/her
behalf, both the applicant and the designee must provide acceptable identification.
The completed request, as well as a copy of all identification submitted, will be
maintained by the vital records office which processes the request.
Primary IDs Including PHOTO
Secondary IDs
(need at least one, current, expired no more than 60 days)
(need at least two)
-
Alabama Driver’s License
-
-
Out-of-State Driver’s License
Expired, Government-Issued ID
-
-
State-Issued Non-Driver ID
Utility Bill (No more than 6 months old)
-
-
Work ID (If applicant is making personal
U.S. or Foreign Passport
-
U.S. Certificate of Naturalization
request)
-
-
Vehicle Registration or Vehicle Title
Certificate of Citizenship
-
-
Property Tax Bill
U.S. Military ID
-
-
Work ID (If applicant is employee of
Military Discharge (DD Form 214)
-
Voter Registration Card
agency/company making request)
-
-
Alien Resident Card (Temporary or
Health Insurance Card
-
Permanent)
Social Security Correspondence (not
-
U.S. Employment Authorization Card
Card)
-
-
Citizenship ID Card
U.S. Selective Service Card
-
-
Recent DMV Receipt for Fines Paid
Tribal ID
-
-
Pilot’s License
Fishing or Hunting License
-
-
Boating License
Copy of Police Report or other official
-
documents which support theft, in cases
Concealed Weapons License
-
Ex-Felon ID
where individual’s ID has been stolen
-
-
Autism Spectrum Card
Inmate ID issued by the U.S. Dept of
-
Immunization (Shot) Record
Justice w/ following documentation:
o Supporting documents from
institution if inmate is still in
*In special cases where applicant is unable to
provide any of these documents, please contact
custody, letter of release from
CHS at 334.206.5418.
institution if inmate has been
released
-
School ID (Must include current school
term)
-
Alabama Voter Identification Card

Download Form ADPH-HS 88 Application to Request a New Birth Certificate After Adoption - Alabama

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