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The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

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Commemorative Certificates

Florida Dept. of Health, Bureau of Vital Statistics

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How to order a Florida Commemorative Birth Certificate 

A commemorative certificate is signed by the current Governor and the State Registrar of the Bureau of Vital Statistics. The certificate is suitable for framing and preserving as a family heirloom. A Commemorative certificate is not acceptable for official purposes.

Please note limited births were recorded between 1850 and 1917. Time of Birth was not collected on birth events between 1949-1969.

To view samples of our commemorative certificates, click on the links below;

Regular Certificate Birth  (191K pdf)

Beach Certificate Birth  (135K pdf)

Palm Certificate Birth   (139K pdf)

 

Who can request a commemorative birth certificate?

Births less than 100 years old are confidential and may only be issued to:

  • Registrant (name on the record) if of legal age (18)
  • Parent(s) listed on the Birth Record
  • Legal guardian (must provide guardianship papers)
  • Legal representative of one of the above persons (must provide documentation)
  • By Court Order (must provide copy of court order)
  • Upon receipt of registrant’s death record, a commemorative birth certificate marked “Deceased” on the back may be issued to the spouse, child, grandchild, or sibling, if of legal age.

VALID PHOTO IDENTIFICATION IS REQUIRED WHEN REQUESTING A COMMEMORATIVE BIRTH RECORD.

If applicant is not one of the above, the application must be accompanied with a notarized Affidavit to Release a Birth Certificate (DH Form 1958) signed by one of the above, along with any supporting documentation and a copy of valid photo ID of both the person authorizing release and the applicant.

Ordering a Commemorative Birth Certificate

Any person who willfully and knowingly provides any false information on a certificate, record or report required by Chapter 382, Florida Statutes, or on an application or affidavit, or who obtains confidential information from any Vital Record under false or fraudulent purposes, commits a felony of the third degree, punishable as provided in Chapter 775, Florida Statutes.

  • ORDER BY MAIL FROM FLORIDA BUREAU OF VITAL STATISTICS

The Bureau of Vital Statistics may be reached at (904) 359-6900, ext. 9000. Download and complete the form to mail in your request.

DH 726C Application for Commemorative Birth Certificate (pdf 123K)

Fees:    A 9.00 search fee is included in all orders and is NON-REFUNDABLE. If no record is found a certified “No Record Found” statement will be issued.

$34First commemorative certificate (includes one computer-generated certification)
$25Additional commemorative certificates
$4Additional computer-generated certifications
Walk-in:  1217 N Pearl Street, Jacksonville, FL 32202
Lobby hours: M-F 8:00 a.m. – 4:30 p.m.
Same day service is not available for commemorative certificates. Walk-in payments may be made in the form of cash, check, money order, Visa, and Mastercard. 

Mail-in:  Florida Bureau of Vital Statistics, P.O. Box 210, Jacksonville, Fl 32231-0042

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.

Email to VitalStats@flhealth.gov