West Virginia Certificate of Birth Resulting in Stillbirth Application
Official state formStillbirth and pregnancy lossFree downloadLast verified November 10, 2026
Request for a certified copy of a West Virginia Certificate of Birth Resulting in Stillbirth. It goes to the Vital Registration Office.
Who can use this form
- Only a parent listed on the originally filed Report of Fetal Death
What to send with it
- Completed and signed application
- Copy of valid ID: one primary or two secondary documents
- Check or money order for $12 per copy, payable to Vital Registration (no cash)
Where to send it
- Mail to
- Vital Registration Room 165 350 Capitol Street Charleston, WV 25301-3701
- State fee
- $12.00 per copy
- Typical processing
- Not provided
- Form revision
- Last Revised 5/26/15
- Source
- Official government page