Wyoming Affidavit for Homeless Unemancipated Minor to Obtain Birth Certificate
Official state formOther requestsFree downloadLast verified November 10, 2026
Lets a homeless unemancipated minor, 16 or older, obtain their own birth certificate. The minor signs before a notary and two adult witnesses sign declarations. It is sent to Vital Records Services.
Who can use this form
- A minor who is at least 16
- Lives apart from parents who consent to or accept the arrangement
- Is homeless and manages their own finances
What to send with it
- Affidavit signed by the minor before a notary
- Declaration of a first witness: an attorney, health care provider, clergy member or school administrator or counselor
- Declaration of a second witness in one of the same roles
- Clergy witnesses also verify they have no felony conviction
Where to send it
- Mail to
- Vital Records Services Hathaway Building Cheyenne, WY 82002
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- WDH-VRS-Affidavit-Unemancipated-Minor-Form-2026
- Source
- Official government page