Pursuant to Section 103577 of the Health and Safety Code, a fee-exempt copy of a birth record may be issued to an eligible homeless person, or homeless child or youth. Eligible persons must present an affidavit signed by an agent for a homeless services provider to receive a fee-exempt copy.
Forms
Information
- A fee-exempt copy of a birth record may be obtained from the local registrar or county recorder office in the county where the registrant was born.
- A fee-exempt copy cannot be obtained from the State Registrar.
- Each eligible person may receive only one fee-exempt birth record, per application.
- Requests for fee-exempt copies are still subject to other requirements outlined in the application form. Applications for a certified copy of a birth record may be obtained by contacting the vital records office in the county where the birth occurred.
- Requests may be submitted in person, by mail, or by fax.
Eligibility Requirements
- Requests may be made by a homeless person, child or youth who can verify status as homeless.
- Requests may be made by a homeless person, child, or youth on behalf of themselves or by any person lawfully entitled to request a certified record of live birth on behalf of a homeless person, child, or youth.
- A “homeless person” and a “homeless child or youth” have the same meaning as defined in Section 11301 et seq. of Title 42 of the United States Code.
- A “homeless services provider,” as defined by statute, who has knowledge of a person’s status as homeless, must provide verification through completion of the affidavit.
- The affidavit will not be considered complete unless signed by both the homeless services provider and the person making the request for the birth record.
- The affidavit form can be obtained in person at any of our locations and is also available online.
A “homeless services provider” includes:
- A governmental or nonprofit agency receiving federal, state, or county or municipal funding to provide services to a “homeless person” or “homeless child or youth,” or that is otherwise sanctioned to provide those services by a local homeless continuum of care organization.
- An attorney licensed to practice law in this state.
- A local educational agency liaison for homeless children and youth designated as such pursuant to Section 11432(g)(1)(J)(ii) of Title 42 of the United States Code, or a school social worker.
- A human services provider or public social services provider funded by the State of California to provide homeless children or youth services, health services, mental or behavioral health services, substance use disorder services, or public assistance or employment services.
- A law enforcement officer designated as a liaison to the homeless population by a local police department or sheriff’s department within the state.
