Kansas Application for Certificate of Stillbirth (VS-239)
Official state formStillbirth and pregnancy lossForm VS-239Free downloadLast verified November 12, 2026
Application for a certified copy of a Kansas stillbirth certificate. The requester chooses a certificate that includes the cause of death or one that does not. It is mailed to the Kansas Office of Vital Statistics.
Who can use this form
- Someone named on the record, an immediate family member, or a person with legal proof the record is needed for personal or property rights (K.S.A. 65-2422d).
- Listed: parents, current spouse, adult children, grandparents, siblings, aunts and uncles, niece or nephew, age 18 or older.
- A legal guardian, with a copy of the guardianship papers.
What to send with it
- The completed form with the delivery details (the place of delivery must be in Kansas) and the requester's signature.
- A copy of the front and back of a current legal photo ID, or any two of the alternate documents the form lists if there is no government photo ID.
- $20.00 per certified copy, by check or money order payable to Kansas Vital Statistics. Do not send cash.
- A self-addressed stamped envelope if mailing the request.
Where to send it
- Mail to
- Kansas Office of Vital Statistics 1000 SW Jackson Street, Suite 120 Topeka, KS 66612-2221
- State fee
- $20.00 per certified copy, as printed on the form. The fee covers a 5-year search. If the record is not found, the office keeps $20.00 for the search.
- Typical processing
- Not provided
- Form revision
- rev 12/22
- Source
- Official government page