Michigan Birth Certificate Application (Form DCH-0569-BX) (DCH-0569-BX)
Official state formForm DCH-0569-BXFree downloadLast verified November 9, 2026
Application for a certified copy of a Michigan birth record. It is mailed to Vital Records at the Michigan Department of Health and Human Services (MDHHS).
Who can use this form
- The person named on the record
- A parent named on the record (only adoptive parents if adopted)
- A legal guardian, custodial party or power of attorney, with legal documents
- A licensed attorney with a letter of representation
- A legal heir of a deceased person (death certificate required if the death was outside Michigan)
What to send with it
- The completed application, signed by hand in ink
- A photocopy of your valid ID (the form lists accepted ID tiers)
- Court order or other legal documentation if you are not the person on the record or a parent
- A check or money order payable to State of Michigan
Where to send it
- Mail to
- Vital Records Requests P.O. Box 30721 Lansing, MI 48909
- State fee
- $34 for the first copy (includes one-year search), $16 for each additional copy
- Typical processing
- About 10 to 12 weeks by mail
- Source
- Official government page