Missouri Application to Record Birth After 12th Birthday (MO 580-0636 (VS-200))
Official state formDelayed registrationForm MO 580-0636 (VS-200)Free downloadLast verified November 10, 2026
Application to the Bureau of Vital Records to register a delayed certificate of birth for a person 12 or older who was born in Missouri and has no birth record. Once accepted, the application becomes the official delayed certificate.
Who can use this form
- The registrant, now 12 years of age or older and born in Missouri, with no registered birth certificate
- A Statement of No Record must have been issued first
- It cannot be filed for a deceased person
What to send with it
- Page 1 affidavit signed by the registrant before a notary public; the notary should not be related
- Page 2 supporting affidavit, notarized, by a parent, or by an older relative or long-time acquaintance (not a spouse) if both parents are deceased
- Two documents of different types, each over 5 years old, showing name, date and place of birth; one must give the parents' names
- Originals only, in permanent black ink
Where to send it
- Mail to
- DHSS - Bureau of Vital Records 930 Wildwood Dr. Jefferson City, MO 65109
- State fee
- The $15.00 search fee already paid with the application that produced the Statement of No Record is applied to register the delayed birth. A copy afterwards needs a new application and $15.00 per copy.
- Typical processing
- Not provided
- Form revision
- 3-2024
- Source
- Official government page