Medium

A certified copy of a fetal death record (or birth resulting in stillbirth) may only be requested by a parent named on the record, an authorized representative or by an order from a court of competent jurisdiction.

 

Do I need any identification to make a request?

Yes. You must submit a legible photocopy of one of the following forms of primary photo identification with your request. The identification CANNOT be EXPIRED!

 

CategoryComment
Driver's LicenseIssued by a U.S. state or territory's Department of Transportation, or by a country.  An Expired driver's licenses can be accepted if they expired in the last 30 days.
Photo ID CardIssued by a U.S. state or territory's Department of Transportation.  Must be verifiable by the issuing agency, and must contain either an issue or an expiration date.
Tribal ID CardIssued by the U.S. Bureau of Indian Affairs.
U.S. Military ID CardActive duty, dependent, retired, reserve or National Guard.
U.S. PassportIssued by the U.S. Department of State.
U.S. VisaIssued by the U.S. Department of State.
U.S. Permanent Resident CardIssued by the U.S. Department of Homeland Security.

 

If you do not have one of the prior primary forms of identification, you must provide a legible photocopy of two of the following.  EXPIRED licenses or ID cards will NOT be accepted!

 

CategoryComment
Bank StatementMust contain current address and be less than three months old.
Motor Vehicle Registration CardIssued by a U.S. state or territory and must be less than one year old and contain current address.
Social Security CardIssued by U.S. Social Security Administration.
Social Services CardIssued by a U.S. state or territory. (includes Medicaid/Medicare cards)
Tribal Enrollment RecordIssued by a Native American Tribe.  Must contain DOB.  May also be called a Certificate of Indian Blood.
Utility BillMust contain current address and be less than three months old.
Paycheck Stub or W-2 (only one of these can be used)The paycheck stub must have been issued within the last three months, and the W-2 within the last tax year and must include the name, SSN and name and address of the employer.
DD Form 214Certificate of Release or Discharge from Active Duty

 

If you cannot provide any of these forms of identification or if you have any other questions related to these requirements, please call our office at (701) 328-2360 or contact us by e-mail at vitalrec@nd.gov

 

How do I apply for a Fetal Death Record by Mail?

  1. Download and complete the fetal death request application form below.
  2. Include a check or money order made out to the "ND DHHS" for all required fees.
  3. Include primary or secondary forms of identification.
  4. Mail form, fees and identification to:  Vital Records, 600 E. Boulevard Ave. Dept 325, Bismarck, ND 58505-0250

SFN 61643 - Fetal Death Request Form