Missouri Affidavit of Homeless or Unaccompanied Youth Status for Fee Exempt Birth Certificate (MO 580-3346)
Official state formOther copy requestsForm MO 580-3346Free downloadLast verified November 10, 2026
Affidavit that gives a homeless youth under 21 or an unaccompanied youth one fee-exempt certified copy of a birth certificate. It is sent with the birth record application to the Bureau of Vital Records.
Who can use this form
- The parent or guardian of a homeless youth under twenty-one (21)
- An unaccompanied youth; no parent or guardian consent or signature is needed
What to send with it
- The affidavit, signed by both the requestor and a homeless services provider
- The application for a certified copy of a birth record, meeting all other requirements
Where to send it
- Mail to
- DHSS - Bureau of Vital Records 930 Wildwood Dr. Jefferson City, MO 65109
- State fee
- No fee for one certified copy under section 193.265 RSMo. The statutory fee applies to additional copies.
- Typical processing
- Not provided
- Form revision
- 8-2020
- Source
- Official government page