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Mississippi Birth Certificate Application (Form 522) (522)

Official state formForm 522Free downloadLast verified November 9, 2026

Form 522 is the application to order a certified copy of a Mississippi birth certificate. It is filed with the Mississippi State Department of Health, Vital Records Office.

Who can use this form

  • The person named on the record, if of legal age
  • A parent listed on the record, a spouse, sibling, grandparent or child
  • A legal guardian or legal representative, with proof
  • Anyone else by court order

What to send with it

  • The completed and signed application
  • A copy of a valid photo ID (or two secondary IDs showing your name and address)
  • The state fee by check or money order payable to Mississippi Vital Records

Where to send it

Mail to
Mississippi State Department of Health Vital Records Office P.O. Box 1700 Jackson, MS 39215-1700
State fee
Not provided
Typical processing
7 to 10 business days, plus shipping time
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Mississippi Birth Certificate Application (Form 522) (522) | Mississippi Form