Pennsylvania Birth Certificate Application (Form H105.102) (H105.102)
Official state formForm H105.102Free downloadLast verified November 9, 2026
Form H105.102 is the application to order a certified copy of a Pennsylvania birth certificate. It is filed with the Pennsylvania Department of Health, Division of Vital Records.
Who can use this form
- The person named on the record
- A spouse, parent, step-parent, sibling or half sibling
- A child (16 or older for mail and in-person requests), step-child or grandchild
- A grandparent or great-grandparent
- A power of attorney or legal representative, with supporting documents
What to send with it
- The completed and signed application
- A photocopy of your valid photo ID
- Proof of your relationship, such as a marriage certificate for a step-parent or step-child
- The state fee by check or money order payable to Vital Records
Where to send it
- Mail to
- Department of Health Division of Vital Records P.O. Box 1528 New Castle, PA 16103
- State fee
- Not provided
- Typical processing
- About 2 to 3 weeks
- Source
- Official government page