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California Heirloom Birth Certificate Application (CDPH 9133)

Official state formCommemorative certificatesForm CDPH 9133Free downloadLast verified November 10, 2026

Mail application for a decorative heirloom birth certificate. The form states that the heirloom certificate is not a valid document to establish identity. It is mailed to the state vital records office in Sacramento.

Who can use this form

  • The form does not limit who may apply
  • The applicant gives a name, mailing address and reason for the request

What to send with it

  • Completed CDPH 9133, one application per heirloom record
  • $44 by check or money order in US dollars payable to CDPH-Vital Records. No cash

Where to send it

Mail to
California Department of Public Health Vital Records - MS 5103 P.O. Box 997410 Sacramento, CA 95899-7410
State fee
The form (4/2021) prints $44 per copy. This fee is not listed on the office's current fees page, so it could not be confirmed against current fees.
Typical processing
Not provided
Form revision
4/2021
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California Heirloom Birth Certificate Application (CDPH 9133) | California Form