EB2Gov VitalRecordRequest

Please Note: A valid picture ID is required in order to process your request. A legible photocopy of the applicant's government issue photo ID needs to be included with this request. In the absence of acceptable picture identification the applicant shall complete the form Documentation Evidence for Individuals Not Possessing An Acceptable Picture Identification

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Notice: Vital record certificates are available for New Hampshire events only. Birth Certificates for births occurring outside Chesterfield, NH are not available prior to 1935.

How Many Copies?

Full Name of Child

Child's Birthdate

City

State

Gender

Full Name of Father/Parent

Full Maiden Name of Mother/Parent

Reason for Certificate Request

Relationship to Registrant

Notice: Vital record certificates are available for New Hampshire events only. Death Certificates for deaths occurring outside Chesterfield, NH are not available prior to 1965.

How Many Copies?

Full Name of Deceased

Gender of Deceased

Date of Death

Place of Death (City, State)

Issued With Cause Without Cause

Reason for Certificate Request

Relationship to Registrant

Notice: Vital record certificates are available for New Hampshire events only. Certificates for Marriages occurring outside Chesterfield, NH are not available prior to 1960.

How Many Copies?

Full Name of Groom/Person A

Full Maiden Name of Bride/Person B

Date of Marriage

Place of Marriage (City, State)

Reason for Certificate Request

Relationship to Registrant

Notice: Vital record certificates are available for New Hampshire events only. Certificates for Divorces occurring outside Chesterfield, NH are only available for the years 1979 to within 6 months from the present search date.

How Many Copies?

Full Name of Husband/Person A

Full Name of Wife/Person B

Date of Decree

Place of Decree (City, State)

Reason for Certificate Request

Relationship to Registrant

Notice: The Decorative Non-Certified Heirloom Birth Certificate cannot be processed by your NH Municipality. To obtain this document visit here.

Notice: The Non-Certified Pre-adoption Birth Record cannot be processed by your NH Municipality. To obtain this document visit here.

Notice: Vital records will be shipped to the applicant's address only. Any person shall be guilty of a CLASS B Felony if he/she willfully and knowingly makes any false statement in an application for a certified copy of a vital record (RSA 5-C:9).

First Name

Middle Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Shipping Options

IMPORTANT INFORMATION

All record requests are subject to locating and researching the record as well as printing and preparing the document for shipment. This process can take up to 2-3 business days and may affect the shipment dates.
All record requests are final, and charges will not be refunded regardless of whether the document is produced, as the agency incurs fees from the State of NH for all research completed.
Processing time and shipment may be delayed until proper identification is received by the agency.
NH vital records are considered to be private and access to them is restricted by statute to those individuals who have a "direct and tangible interest" in the record. All vital record disclosure limitations can be reviewed in RSA 5-C:9.
The above listed address must be your legal address. Vital Records can only be shipped to your legal address.

I have read and I agree to all of the above bullet points.

Attention: A valid picture ID is required in order to process your request. A legible photocopy of the applicant's Government Issued photo ID needs to be included with your request. You may provide this ID in one of the following ways:

Mail:	Mary Ewell, 490 Route 63 , PO Box 64, Chesterfield, NH, 03443
E-mail:	townclerk@nhchesterfield.com
Fax:	603-363-8049
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Fees
Certificate Fees:			0.00
EB2Gov Transaction Fees:			$1.75
Shipping Fees:			$0.00
Total Fees:			0.00

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