West Virginia Birth Certificate Permission Slip
Official state formOther requestsFree downloadLast verified November 10, 2026
Lets the person on a birth certificate, or a parent of a minor, authorize a named person to pick up the certificate at the Vital Registration Office walk-in counter. It is sent by fax.
Who can use this form
- The person named on the birth certificate
- The mother or father, for a minor child
- The office releases a certificate in person only to a brother, sister, parent, grandparent, grandchild, spouse or child of the person named
What to send with it
- Signed permission slip naming the person who will pick up the certificate
- Names of the certificate holder's mother and father, date of birth, and city and county of birth
- Legible copy of the photo ID of the person giving permission
- Fax to (304) 558-8001; the person who picks up the certificate shows their own photo ID
Where to send it
- Mail to
- See the form for where to file it.
- State fee
- Not provided
- Typical processing
- Not provided
- Source
- Official government page