Iowa Commemorative Birth Certificate Application
Official state formCommemorative certificatesFree downloadLast verified November 10, 2026
Application for a commemorative birth certificate or a Certificate of Birth Resulting in Stillbirth. A commemorative certificate is a keepsake, not a legal document. It goes to the Bureau of Health Statistics.
Who can use this form
- Commemorative birth certificate: the person named on the record
- Also that person's spouse, children, legal parents, grandparents, grandchildren, siblings, legal representative or guardian
- Legal guardians, legal representatives and siblings must send additional proof of entitlement
- Certificate of Birth Resulting in Stillbirth: only the parent or parents named on the Certificate of Fetal Death
What to send with it
- The completed application; the event must have occurred in Iowa
- A copy of your current government-issued photo ID
- Payment in U.S. funds by check or money order (cash is accepted in person only)
- A notarized signature when you mail the request
Where to send it
- Mail to
- Iowa Department of Health and Human Services Bureau of Health Statistics Lucas State Office Building 1st Floor, 321 E. 12th Street Des Moines, Iowa 50319-0075
- State fee
- $35 for each commemorative birth certificate; $15 for each Certificate of Birth Resulting in Stillbirth
- Typical processing
- The form says certificates are delivered within 60 days of application; the office page says about 60 business days.
- Form revision
- UPDATED January, 2024
- Source
- Official government page