Utah Stillbirth Certificate Application, 20+ Weeks of Pregnancy (DHHS-OVRS-117)
Official state formStillbirth and pregnancy lossForm DHHS-OVRS-117Free downloadLast verified November 10, 2026
Application for a certified copy of a Utah stillbirth certificate when the delivery was on or after 20 weeks of gestation. It is sent to the Utah Office of Vital Records and Statistics.
Who can use this form
- A parent
- A sibling
- A grandparent
- Another person with documentary proof of relationship or legal need
What to send with it
- The completed application
- A check or money order payable to "Vital Records"
- A copy of your ID, front and back: one primary ID or two secondary IDs from the list on page 2
Where to send it
- Mail to
- Office of Vital Records and Statistics PO Box 141012 SLC, UT 84114-1012
- State fee
- $18 search fee, which includes one certified copy. Additional copies ordered at the same time $10 each. Standard U.S. shipping $1. Expedited processing $25. Expedited shipping (U.S. only) $30. Fees are non-refundable.
- Typical processing
- Allow at least 6 weeks for mail orders, according to the office's general ordering page.
- Form revision
- 2026
- Source
- Official government page