Missouri Birth Certificate Application (Form MO 580-0641) (MO 580-0641)
Official state formForm MO 580-0641Free downloadLast verified November 9, 2026
Form MO 580-0641 is used to request a certified copy of a Missouri birth record from the Missouri Department of Health and Senior Services, Bureau of Vital Records. The same form also covers death records.
Who can use this form
- The person named on the record
- Immediate family members in the direct line of descent, who must identify at least one parent on the record
- A parent or legal guardian of a minor, a foster parent or a stepparent, with proof
- An attorney or other official representative acting for the registrant or family
- Others who show a direct and tangible interest
What to send with it
- The completed application, signed and notarized for mail requests
- Any required tangible interest or guardianship documents
- A check or money order for the fee, payable to the Missouri Department of Health and Senior Services
- A self-addressed stamped return envelope
Where to send it
- Mail to
- DHSS - Bureau of Vital Records 930 Wildwood Dr. Jefferson City, MO 65109
- State fee
- $15 per certified copy
- Typical processing
- About 4 to 8 weeks by mail
- Source
- Official government page