Birth Certificate Birth Card (sold as pair only) Death Certificate Number of Copies Requested Number of Pairs Requested Number of Copies Requested $1500 each $2400 $700 each SUBTOTAL Mail orders add $050 state charge per transaction (no coins) TOTAL FEES DUE Record Information Name at Birth/Death First Middle Last Date ofBirth Certificate Application Complete this form to order a certified copy of a Minnesota birth certificate You are required to provide the information requested on this form and pay the required fees to obtaina birth certificate If we cannot locate the record with the information you provide, we will send you a certified "Statement of NoFull date of birth (month, day, year) County of birth;
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