West Virginia Certificate of Adoption (VS - CA)
Official state formAdoptionForm VS - CAFree downloadLast verified November 10, 2026
Report of a final adoption decree, completed for the circuit court. Adoptive parents without a lawyer fill in parts A and B. The Circuit Clerk completes part C and mails it to the Vital Registration Office.
Who can use this form
- Parts A and B: a WV DHHR representative, a licensed adoption agency representative, the petitioner's attorney, or an adoptive parent acting without a lawyer
- Part C: the Clerk of Circuit Court
What to send with it
- Completed form with part C certified and sealed by the Circuit Clerk
- The clerk forwards it within 10 days after the end of the month of the final decree
- A certified copy of the final decree with all the needed information may be sent instead, but the form is preferred
Where to send it
- Mail to
- Vital Registration Office ATT: Corrections Unit PO Box 11012 Charleston, WV 25339-1012
- State fee
- No charge to prepare a new birth certificate due to adoption (certified copy not included)
- Typical processing
- Not provided
- Form revision
- Rev. 7/2011
- Source
- Official government page