Fillable FORM 3918 (REVISED 09/2017): REQUEST FOR SEARCH OF (Emanuel County Board of Commissioners)

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FORM 3918 (REVISED 09/2017): REQUEST FOR SEARCH OF (Emanuel County Board of Commissioners)

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BROWSE EMANUEL COUNTY BOARD OF COMMISSIONERS (GA) FORMS

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REQUEST FOR SEARCH OF BIRTH
FORM 3918 (REVISED 09/2017)
PLEASE ADDRESS ALL CORRESPONDENCE TO THE ADDRESS BELOW.
STATE OFFICE OF VITAL RECORDS1680 PHOENIX BLVD. SUITE 100, ATLANTA, GA 30349 PHONE 404.679.4702
At the State Office, birth records are available from January 1919 to the present. The fee for searches of vital
records has been established in accordance with GA Code Ann., 31-10 of the Official Code of Georgia. The $25.00
fee includes a certified copy if the record is found on file. Each additional copy paid for at the same time is $5.00.
The search fee is non-refundable.
Example: 1 Certified Copy $25.00
+2 Additional Copies $10.00
$35.00
If this request is being mailed, please forward this completed form with a U.S. Money Order or certified check for
the correct amount made payable to the State Office of Vital Records. A valid copy of your Photo ID must
accompany this request. Please do not send cash by mail.
GA Code Ann., 31-10-26 provides that certified copies of birth certificates be issued only to registrants (i.e. the
person whose birth certificate is being requested) or any applicant having a direct and tangible interest such as a
parent, guardian, or legal representative.
PLEASE PRINT OR TYPE ALL INFORMATION LEGIBLY AND CORRECTLY BELOW.
Enter total number of copies requested here: ______________ Total Amount Due: __________________________
Section 1: REGISTRANT’S INFORMATION
LEGAL FIRST NAME
MIDDLE NAME
LAST NAME AT BIRTH
SEX
DOB (MONTH, DAY, YEAR)
PLACE OF BIRTH
AGE
RACE/ETHNICITY
Section 2: PARENTS’ INFORMATION
Please type or print the full legal name of the mother/parent 1 on the first row and father/parent 2 on the second
row.
LEGAL FIRST NAME OF MOTHER/PARENT 1
MIDDLE NAME
LAST NAME
LAST NAME AT BIRTH
LEGAL FIRST NAME OF FATHER/PARENT 2
MIDDLE NAME
LAST NAME
LAST NAME AT BIRTH
Section 3: REQUESTER’S INFORMATION
FIRST NAME
MIDDLE NAME
LAST NAME
STREET NAME AND No/APARTMENT No
CITY
STATE
ZIP CODE
PHONE NUMBER
E-MAIL ADDRESS
RELATIONSHIP (IF OTHER THAN SELF)
SIGNATURE OF REQUESTER
Pursuant to O.C.G.A. GA Code Ann., 31-10; Section 31: Any person who willfully or knowingly supplies false
information on this form to be used for any purpose of deception with intent to defraud; willfully uses or attempts
to use any certificate of birth or copy of any record of birth knowing that such certificate was issued upon a record
which was false or which relates to the birth of another person may be fined not more than $1,000 or imprisoned
for not more than five (5) years, or both upon conviction.
REQUEST FOR SEARCH OF BIRTH
FORM 3918 (REVISED 09/2017)
PLEASE ADDRESS ALL CORRESPONDENCE TO THE ADDRESS BELOW.
STATE OFFICE OF VITAL RECORDS1680 PHOENIX BLVD. SUITE 100, ATLANTA, GA 30349 PHONE 404.679.4702
Georgia law and the Department of Public Health regulations require that all requests for vital records include
the signature and picture ID of the requestor and the proper fee.
Typically, the person requesting a certified copy of a birth record needs only to provide:
1. A completed and signed request form which can be downloaded by clicking here.
2. Provide the applicable fee(s) noted below
3. A photocopy of your valid photo ID such as one of the following:
• Georgia Driver’s license unexpired or expired for not more than one year
• State of Georgia Identification Card unexpired or expired for not more than one year
• State of Georgia Weapons Carry License - New
• Unexpired driver’s license issued by another U.S. State, jurisdiction or territory
• Unexpired official Identification Card issued by another U.S. State, jurisdiction or territory
• Unexpired U.S. Passport
• Unexpired Foreign Passport
• U.S. Military Identification, Military Dependent Identification, Veteran’s Identification
• Unexpired Consulate Card
• Transportation ID
• Debit Card with Picture
• Employer ID Card
• School, University, or College Identification Card
• DMV ID Card
• Department of Corrections Identification Card
However, as explained below, there are instances in which specific documentation is required based on who is
requesting the record.
• The person named on the certificate- If the person named on the certificate (i.e. the registrant) is the
requestor, that person must provide valid photo identification at the time of the request.
• The parent(s) named on the birth record- Must provide valid picture identification.
• An authorized legal guardian or agent- Any person who has legal custody or control of a minor child must
provide a certified copy of the court order establishing guardianship and legal custody.
• Grandparents of the person named on the certificate- Must provide proof of relationship such as the birth
certificate of the registrant’s parent.
• An adult child or adult sibling of the person named on the certificate- Must provide proof of relationship
by providing a copy of his or her birth certificate listing one of the same parents, along with his or her
valid government issued picture identification which includes signature.
• The spouse of the person named on the certificate- Must provide a copy of the marriage certificate, a
photo copy of the spouse’s picture identification, which includes the spouse’s signature, with a notarized
letter from the spouse giving permission.
• Attorney-Must represent an immediate family member and provide a notarized letter on letterhead
signed by the attorney; provide bar number indicating reason for the request and whom they represent;
provide supporting documentation with the fee; provide a notarized release from the biological mother,
in the event of an adoption.
• State or Federal Government Officials-The State Registrar or the local custodian may disclose data from
Vital Records to authorized representatives of Federal, State, or County agencies of government which
request such data in the conduct of their official duties.
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FORM 3918 (REVISED 092017): REQUEST FOR SEARCH OF (Emanuel County Board of Commissioners)

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Completed 17 July 2020

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