California Still Birth and Fetal Death Certificate Copy Application (VS 13-E / VS 12)
Official state formStillbirth and pregnancy lossForm VS 13-E / VS 12Free downloadLast verified November 10, 2026
One PDF with two mail applications: VS 13-E for a certified copy of a Certificate of Still Birth and VS 12 for a certified copy of a fetal death record. Both are mailed to the state vital records office in Sacramento.
Who can use this form
- Still birth copy (VS 13-E): only a parent named on the record
- Fetal death copy (VS 12): anyone who can give enough information to identify the record
What to send with it
- Completed VS 13-E (still birth) or VS 12 (fetal death) application
- $28 per still birth copy or $23 per fetal death copy, 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
- $28 per copy for a still birth certificate (VS 13-E); $23 per copy for a fetal death record (VS 12).
- Typical processing
- The form does not state a time. The office's processing times page lists an average of 4 to 6 weeks for certified copies.
- Form revision
- 01/2026
- Source
- Official government page