Pennsylvania Application for a Stillborn Birth Certificate (HD02090F)
Official state formStillbirth and pregnancy lossForm HD02090FFree downloadLast verified November 10, 2026
Orders a commemorative, noncertified stillborn birth certificate that summarizes a Pennsylvania fetal death record. It is not a legal document. Mail it to the Division of Vital Records in New Castle.
Who can use this form
- Only a parent listed on the fetal death record
- Available for Pennsylvania fetal death records from 1950 onward
What to send with it
- Completed and signed application
- Photocopy of a valid government-issued photo ID, or two current documents that show your name and address
- Check or money order payable to "VITAL RECORDS" for any copy after the first
- For the armed forces fee waiver: a copy of the Military ID or DD214
Where to send it
- Mail to
- Department of Health Division of Vital Records PO Box 1528 New Castle, PA 16103
- State fee
- The first certificate is free. $20.00 for each later certificate.
- Typical processing
- Up to 4 weeks once received at the New Castle office
- Form revision
- REV 01/25
- Source
- Official government page