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Birth Certificate Online Payment Form

  1. SJCHD logoCMYK
  2. Birth Certificate Payment Form
  3. County, City, and State are required

  4. Upload a picture of your valid government issued photo ID.

  5. Provide the names of both Parent 1 and Parent 2 including maiden name, if either Parent was known by a different name.

  6. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  7. Birth Certificate (Full Size)
    Certified Copy
  8. Price
  9. Limit 5 per year
  10. Birth Certificates (Wallet Size)
    Certified Copy
  11. Price
  12. Limit 5 per year
  13. Online Payment Fees:

    Online payments are processed by Forte. A fee of 2.55% or $1.55 (whichever is greater) will be assessed for all credit card payments. Electronic Checks are also accepted, and will be assessed a flat $2.00 for any payment under $50,000. The appropriate fee will be added to the total cost of your payment.

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