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South Dakota Affidavit of Homeless Status for Certified Copy of Birth Certificate

Official state formOther requestsFree downloadLast verified November 10, 2026

Notarized affidavit to get one free certified copy of a South Dakota birth certificate for a person experiencing homelessness. It can be filed at any county Register of Deeds or the state office.

Who can use this form

  • The person experiencing homelessness signs Section I
  • A homeless services provider who knows the person's housing status signs Section II
  • The person's spouse, child, parent, guardian, next of kin or authorized representative may apply for the copy

What to send with it

  • Affidavit signed and notarized by both the person and the provider
  • The completed South Dakota Vital Records Request application
  • The identification the application requires
  • Free copy is limited to one per lifetime

Where to send it

Mail to
See the form for where to file it.
State fee
Fee exempt. Limited to one copy per lifetime.
Typical processing
Not provided
Form revision
Issued 06/2024; Revised 06/2025
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South Dakota Affidavit of Homeless Status for Certified Copy of Birth Certificate | South Dakota Form