City of Bryan Vital Statistics Online Birth Certificate Requests

This is an official online vital record request.

Please note the following:

The fee payment will be paid through Permitium Payments. The charge will show on your credit card statement as 'PermVitalRecs'

Attention:

The State Office is requiring that all applicants upload a form of identification when submitting their application. Click on the button below for information on the forms of identification acceptable.

Failure to provide valid identification, will result in denial of the order.
Failure to provide supporting documentation, will result in denial of the order.
Please make sure the information on the application matches the information that is on the record requested to avoid delays and/or denials.

Click here for list of forms of identification

Click here for information regarding qualified applicants

Click here for FAQs on applying for a Birth/Death Certificate

Delivery Address: Because our office utilizes FedEx shipping, we CAN NOT deliver birth certificates to a P.O. Box. If you attempt to use a P.O. Box as your delivery address, please note that it will significantly delay the processing of your request.

Please Enter The Full Name Of Deceased:

Last Name: ^{(full name, no initials)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Parent Names of the Deceased:

Mother's Last Name:

Mother's First Name:

Mother's Maiden Name:

Father's Last Name:

Father's First Name:

Please Enter The Location Of Death:

Date of Death:

Confirm Death Year:

Death Location City:

Place of Death:

Death County:

Death State:

Funeral Home

Funeral Home:

Please Enter The Requestor's Name:

Last Name: ^{(full name, no initials)}

First Name:

Middle Name:

Maiden Name:

Suffix:

Last 4 SSN:

Last 4 SSN: ^(confirm)

Requestor Date of Birth:

Requestor Current Age:

Requestor's Current Residence Address: ^{(this may be different than the mailing address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Requestor's Current Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State: ^(region)

Zip Code: ^{(postal code)}

Country:

Requestor's Contact Telephone Numbers: ^{(###-###-####)}

^Home:

^Work:

^{Cell Phone:}

^Fax:

Updates via Text Message?

Yes No

Requestor's Driver's License: ^{(or other State Issued ID)}

^{ID Number:}

^{Issuing State:}

Requestor's Email:

^Address:

^Confirm:

Uploaded Files

^{File uploads must be in a jpg, tif, png, gif, or pdf format. Each file must have a file size of 50MB or less}

I will mail these documents.

We can only accept valid government issued identification (e.g. current driver's license, military ID, etc.).  "SELFIES" ARE NOT VALID FORMS OF IDENTIFICATION AND WILL NOT BE ACCEPTED.

Please upload the FRONT and BACK of the ID.

Please note: Failure to upload the FRONT and BACK of a valid ID at this time will result in delays while processing your request.

Add files...

Special Instructions :

Reason for Request:

Select Reason:

Select Delivery Method:

Please select the document delivery method

I will PICK-UP these documents at:

NOTICE FOR PICK-UP: - There is no additional charge for this service. - Requests will be processed in the order they are received. - You will receive two (2) emails - the first email confirms your order has been placed, the second email notifies you the record is ready for pickup. Note: Orders not picked up within 15 days after the order has been completed will be mailed and no refunds will be approved.

I would like my document(s) delivered via MAIL.

The individual listed on the Death Certificate is:

Select The Information Type(s) Requested:

Total Fee:

$0

AUTHORIZATION NOTIFICATION:

My initials below constitute an electronic signature and authorizes the City of Bryan Vital Statistics to release information and / or my vital record and confirms I have completed all sections accurately and truthfully, including information verifying my identity. I understand that the recipient of the record(s) will use the indicated documents(s) for legitimate interests only and that the information contained therein shall not be further transferred or communicated to any other party or agency without my expressed written consent. I understand the penalty for knowingly making false statements on this form is a third degree felony and may be punishable with up to 2 - 10 years in prison and a fine of up to $10,000 Health and Safety Code of Texas, Chapter 195, Sec. 195.003.

In the event that your certificate cannot be located, you will receive notification from our office and a full refund less the Identity Verify Fee will be issued to you.

I have enclosed the correct fees and understand that they are refundable if no record is found and the order can't be processed. I understand that an incomplete form will not be processed and will be considered closed after expiration of the 30 day notification window. I declare under penalty of perjury that the foregoing is true and correct.

Coupon Code:

Requestor's Initials:

Clear Form

Online Death Certificate Request

Attention:

Click here for list of forms of identification

Click here for information regarding qualified applicants

Click here for FAQs on applying for a Birth/Death Certificate

Please Enter The Full Name Of Deceased:

Parent Names of the Deceased:

Please Enter The Location Of Death:

Other Place of Death:

Funeral Home

Please Enter The Requestor's Name:

Requestor's Current Residence Address: ^{(this may be different than the mailing address)}

Requestor's Current Mailing Address: ^{(if different from residence address)}

Requestor's Contact Telephone Numbers: ^{(###-###-####)}

Requestor's Driver's License: ^{(or other State Issued ID)}

Requestor's Email:

Uploaded Files

Reason for Request:

Select Delivery Method:

Documents Will Be Delivered To: ^{please enter the delivery addresses}

The individual listed on the Death Certificate is:

Other Relationship:

Select The Information Type(s) Requested:

Total Fee:

$0

Online Death Certificate Request

Attention:

Click here for list of forms of identification

Click here for information regarding qualified applicants

Click here for FAQs on applying for a Birth/Death Certificate

Add An Address

A Shipping Address Is Required!

Please Enter The Full Name Of Deceased:

Parent Names of the Deceased:

Please Enter The Location Of Death:

Other Place of Death:

Funeral Home

Please Enter The Requestor's Name:

Requestor's Current Residence Address: (this may be different than the mailing address)

Requestor's Current Mailing Address: (if different from residence address)

Requestor's Contact Telephone Numbers: (###-###-####)

Requestor's Driver's License: (or other State Issued ID)

Requestor's Email:

Uploaded Files

Reason for Request:

Select Delivery Method:

Documents Will Be Delivered To: please enter the delivery addresses

The individual listed on the Death Certificate is:

Other Relationship:

Select The Information Type(s) Requested:

Total Fee:

$0

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Requestor's Current Residence Address: ^{(this may be different than the mailing address)}

Requestor's Current Mailing Address: ^{(if different from residence address)}

Requestor's Contact Telephone Numbers: ^{(###-###-####)}

Requestor's Driver's License: ^{(or other State Issued ID)}

Documents Will Be Delivered To: ^{please enter the delivery addresses}