Utah Birth Certificate Application (Form DHHS-OVRS-104) (DHHS-OVRS-104)
Official state formForm DHHS-OVRS-104Free downloadLast verified November 9, 2026
Form DHHS-OVRS-104 is the application for a certified copy of a Utah birth certificate. It is filed with the Utah Department of Health and Human Services, Office of Vital Records and Statistics.
Who can use this form
- The person named on the certificate
- A parent, spouse, sibling, child, grandparent or grandchild
- Others with documentary proof of relationship or legal need
What to send with it
- The completed and signed application
- A copy of your valid photo ID (or two secondary IDs)
- The state fee by check or money order payable to Vital Records
Where to send it
- Mail to
- Office of Vital Records and Statistics PO Box 141012 Salt Lake City, UT 84114-1012
- State fee
- $22 for the first copy, $10 for each additional copy
- Typical processing
- Not provided
- Source
- Official government page