South Dakota Application for a Certificate of Birth Resulting in Stillbirth
Official state formStillbirth and pregnancy lossFree downloadLast verified November 10, 2026
Application for a parent to request a Certificate of Birth Resulting in Stillbirth. Mail it with a $10 check or money order to the Office of Vital Records.
Who can use this form
- Only the mother or father listed on the record
What to send with it
- Completed form
- A photocopy of your government photo ID in Box A, or have the form notarized in Box B
- Check or money order for $10 payable to Vital Records
- Optional: the name you wish to give your stillborn child
Where to send it
- Mail to
- VITAL RECORDS 221 W Capitol Ave Pierre SD 57501
- State fee
- $10
- Typical processing
- 3-5 business days by mail (office web page)
- Source
- Official government page