Pennsylvania Delayed Report of Live Birth (HD105.018)
Official state formDelayed registrationForm HD105.018Free downloadLast verified November 10, 2026
Reports a birth that took place in Pennsylvania when the report is filed more than seven years after the birth. Once the Department of Health accepts it, it becomes the basis of the birth record. Mail it to the Birth Registry in Harrisburg.
Who can use this form
- A parent filing for a child younger than 18
- The person whose birth is being reported, if 18 or older
- Another person filing on behalf of the individual or parent, who must state the reason and relationship
What to send with it
- Notarized report, signed by all parents listed (for a child) or by the individual; no notary is needed if an original court order is attached
- Copy of the "Certificate of No Birth Record" issued by the Pa. Department of Health, or a letter explaining why the birth was not registered
- Documents that establish the name at birth, place of birth and date of birth, such as a baptismal certificate, childhood medical record or early school record at least five years old
- Or an original court order with a raised seal, plus the evidence given to the court
- A court order is required when the individual is deceased
Where to send it
- Mail to
- Pa. Department of Health Bureau of Health Statistics and Registries ATTN: Birth Registry 555 Walnut St., 6th Floor Harrisburg, PA 17101-1934
- State fee
- No fee is associated with filing a Delayed Report of Live Birth.
- Typical processing
- Not provided
- Form revision
- REV 09/20
- Source
- Official government page