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Missouri Application for Non-Certified Copy of an Original Birth Certificate by Adoptee, Attorney or Birth Parent (MO 580-3139 (VS-902))

Official state formAdoptionForm MO 580-3139 (VS-902)Free downloadLast verified November 10, 2026

Request under the Missouri Adoptee Rights Act for a non-certified copy of an adoptee's original (pre-adoption) birth certificate. It goes to the Bureau of Vital Records by mail or in person in Jefferson City; it cannot be ordered online.

Who can use this form

  • The adoptee
  • The adoptee's attorney
  • A birth parent whose name is listed on the certificate

What to send with it

  • The notarized application
  • The $15 non-refundable search fee, by check or money order payable to Missouri Department of Health and Senior Services
  • The form prints the P.O. Box address; the office's order page says to submit to 930 Wildwood Drive, Jefferson City, MO 65109

Where to send it

Mail to
Bureau of Vital Records P.O. Box 570 Jefferson City, MO 65102-0570
State fee
$15 non-refundable search fee
Typical processing
The office's order page says to allow additional processing time; requests are handled first in, first out. No number of days is given.
Form revision
8-18
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Missouri Application for Non-Certified Copy of an Original Birth Certificate by Adoptee, Attorney or Birth Parent (MO 580-3139 (VS-902)) | Missouri Form