South Carolina Non-Certified Pre-Adoptive Birth Application (4019-ENG-DPH)
Official state formAdoptionForm 4019-ENG-DPHFree downloadLast verified November 10, 2026
An adopted person uses this form to ask the Vital Records Section for a non-certified copy of the original birth certificate and other documents in the sealed adoption file. The copy may not be used for legal purposes.
Who can use this form
- The adopted person completes and signs this form
- The office's website says the adoptee must be 18 or older and born in South Carolina
- The office's website says only the adoptee may apply
What to send with it
- The completed, signed application
- A photocopy of the applicant's current government, school or employer photo ID
- A money order or cashier's check payable to SC DPH
- Per the office's website: each biological parent's consent (already on file or on notarized Form 4402) or a certified death certificate of that parent
- Without a consent form, notarized statement or death certification for a parent, that parent's information may be redacted
Where to send it
- Mail to
- SC DPH - Vital Records Section P.O. Box 2046 West Columbia, SC 29171
- State fee
- $27 non-refundable ($12 search fee plus $15 special filing fee), which includes one copy if the record is found; $3 for each additional copy ordered at the same time.
- Typical processing
- About 4 weeks from the date of receipt. All applications are processed as mail requests.
- Form revision
- 07/2024
- Source
- Official government page