Certified Birth Death Applications

Application for certified copies of Birth and Death Records

WARNING: FALSE APPLICATIONS, ALTERING, MUTILATING, OR COUNTERFEITING CERTIFIED COPIES OF BIRTH CERTIFICATES IS A CRIMINAL OFFENSE UNDER I.C. 16-1-19-6

Notice: I.C. 16-1-16-18 requires the showing of at least one (1) form of identification to issue a certified copy of a birth or death record. If this record is being requested through the mail, a Xerox copy of the requestor’s driver’s license is required. You must be 18 years of age or older to obtain a certified copy of a record. Legitimate birth records are issued to the individual named on the record, a parent or guardian, (Guardianship papers must be presented) spouse, grandparent, brother, sister (21 years or older) or children.

We have records of persons only in Owen County. We have no records prior to 1882. Many births have never been recorded and/or are incomplete. Also, many handwritten records are very difficult to decipher.

Please select type of record requested *

Birth

Death

The cost of a Certified Birth or Death Certificate is $10.00. If the certificate is to be mailed, please enclose a self-addressed stamped envelope.

Full Name on Record *

Date of Birth/Death *

Purpose for which record is to be used

FOR BIRTH RECORDS ONLY

Father’s full name

Father's State of Birth

Mother’s full name

Mother's State of Birth

Signature of person completing this form *

Relationship to person whose record is being requested

Applicant’s mailing address *

City *

State *

Zip *

Phone *