DELAYED CERTIFICATE OF BIRTH
FORM 3908 (REVISED 03/2018)
PLEASE ADDRESS ALL CORRESPONDENCE TO THE ADDRESS BELOW.
STATE OFFICE OF VITAL RECORDS1680 PHOENIX BLVD. SUITE 100, ATLANTA, GA 30349 PHONE 404.679.4702
The top portion of the Delayed Certificate of Birth, must be completed by the registrant (or parent, or the legal representative). ALL
INFORMATION MUST BE TYPED OR PRINTED IN BLACK OR BLUE-BLACK INK. The Delayed Certificate of Birth is a permanent record.
Step 1. Complete the name of the person at the time of birth, sex, date of birth, city, town or location of birth, county of birth, mother’s full
maiden name, mother’s date of birth, mother’s state of birth, father’s full name, father’s date of birth, and the father’s state of birth.
NOTE: If the mother was not married at the time of this birth, no information concerning the father can be listed on the
certificate.
Step 2. The registrant must sign the Delayed Certificate of Birth, in the presence of a notary public. The registrant must also enter the
complete current address of the registrant. If the registrant is under 18 years of age, the parent or guardian must sign the
certificate.
Step 3. The Delayed Certificate of Birth must be notarized in the Affidavit section. The notary shall sign his or her name, enter the date the
information was ‘sworn and subscribed to,” enter the date his or her notary commission expires and impress the notary seal in the
space marked “IMPRESS SEAL HERE.”
NOTE: APPLICANTS OR THEIR REPRESENTATIVE DO NOT ENTER ANY INFORMATION BELOW THE SOLID LINE MARKED “APPLICANT – DO NOT
WRITE BELOW THIS LINE.”
Step 4. The applicant (or representative) must submit the required number of evidence which shows the information listed in the sworn
portion of the form. Records submitted showing information different from information entered will not be accepted. The
minimum facts which must be established will be the following:
(1) the full name of the registrant (person whose birth certificate is being filed);
(2) the date of birth;
(3) place of birth; (must show county or city and state)
(4) the full maiden name of the registrant’s mother, and;
(5) the full name of the registrant’s father unless the parents were not married at the time of conception, or anytime
between conception and birth.
If the Delayed Certificate of Birth is being filed within seven years of the registrant’s birth, the certificate must be accompanied by at least two
different types of evidence, both of which must be filed before the registrant’s third birthday and must have been created at least one year
prior to the date of application. Delayed birth certificates being filed for persons within seven years of age and born in a hospital or
institution, will require a statement from the hospital. At least one document must show the full date of birth and place of birth. The second
document must show the father’s full name, the full maiden name of the mother, the place of birth and the date of birth or age of the
registrant.
If the Delayed Certificate of Birth is being filed seven years or more after the registrant’s birth, the certificate must be accompanied by at least
three different types of evidence. Each document submitted must have been filed at least ten years prior to the date of application to establish
a Delayed Birth Certificate, or within three years of the date of birth. The full date of birth and the place of birth must be shown on at least two
of the documents. The third document must show the father’s full name, the full maiden name of the mother and the date of birth or age of
the registrant.
• Each document submitted must show the registrant’s name and date of birth, or age.
• All documents must show the date the original record was made and by whom.
• All evidence will be returned to the applicant upon review. Altered records or records which show incorrect information will not
be accepted.
AFFIDAVITS OF PERSONAL KNOWLEDGE AND FAMILY BIBLE RECORDS ARE NOT ACCEPTABLE PIECES OF SUPPORTING EVIDENCE TO
ESTABLISH BIRTH FACTS. (Provided by Vital Records Rules and Regulations Chapter 290-1-3.).
ABBREVIATED RECORDS REQUIREMENT CHART
This chart is for establishing a Delayed Certificate of Birth ONLY:
Required Number of Records
At least 10 year old record
Not more than 3 yrs. after the date of birth
Not more than 3 yrs. after the date of birth
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