Minnesota Certificate of Birth Application

If you have questions, please contact us at [email protected] or call 218-333-4148
B102 REV 09/2011
MINNESOTA CERTIFICATE OF BIRTH APPLICATION
REQUESTERS NAME:
PART V: Fee and Payment Information
Item
Number
requested
Fee per
item
Total
One birth certificate
1
$26
$26
Additional birth certificate(s) for the same person
$19 each
Total amount submitted:
(This amount must be at least $26.)
Type of payment:
Money order
Check
If paying by check or money order (make payable to Beltrami County License Center):
Check/money order number:
Checks returned for non-payment will be charged a $30 fee according to Minnesota Statutes, section 604.113, subdivision 2
and civil penalties may be imposed.
Mail application and check/money order to:
Beltrami County License Center
Beltrami County Administration Building
701 Minnesota Ave NW Suite 100
Bemidji, MN 56601
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Minnesota Certificate of Birth Application PDF

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