Blank California Vs 12 PDF Form

What is the California VS 12 form used for?

The California VS 12 form is an application used to request a certified copy of a fetal death record. These records have been maintained by the California Department of Public Health since July 1, 1905. Individuals may need this form for various reasons, including legal matters, personal records, or family history research.

How do I complete the California VS 12 form?

To complete the VS 12 form, you must fill out a separate application for each fetal death record you wish to request. Start by providing your information in the Applicant Information section, including your signature. In the Fetal Death Information section, include as much detail as possible about the fetal death. This can include the names of the parents, the date and location of the fetal death, and the sex of the fetus. Accurate information is crucial for locating the record.

What is the fee for requesting a copy of a fetal death record?

The fee for each copy of a fetal death record is $18. This fee must be submitted with your application. If the record cannot be found, the fee will not be refunded, as it covers the search process. A "Certificate of No Public Record" will be issued if no record exists.

How should I submit my payment for the VS 12 form?

Payments should be made via personal check or postal or bank money order, payable to CDPH Vital Records. It is important to note that cash should not be sent, as the California Department of Public Health cannot be responsible for any cash that is lost or misdirected. Ensure that your payment is attached to the application before mailing it.

Where do I send the completed California VS 12 form?

Completed applications, along with the required fee, should be mailed to the following address: California Department of Public Health, Vital Records – MS 5103, P.O. Box 997410, Sacramento, CA 95899-7410. For any questions or additional information, you can contact the department at (916) 445-2684.

1. Failing to complete a separate application for each fetal death record requested. Each record requires its own application.

2. Not providing a signature in the Applicant Information section. A signature is mandatory for processing the application.

3. Submitting incomplete or inaccurate information in the Fetal Death Information section. This can hinder the ability to locate the record.

4. Neglecting to include the correct fee of $18 for each copy requested. Fees must be submitted in the form of a personal check or money order.

5. Sending cash instead of a check or money order. Cash payments are not accepted and can result in loss or misdirection.

6. Not indicating the number of copies desired on the application. This information is necessary to process the request accurately.

7. Failing to provide a complete mailing address. Incomplete addresses can delay or prevent delivery of the requested copies.

8. Overlooking the requirement to attach the check or money order to the application. This step is crucial for processing.

9. Forgetting to include a daytime telephone number. A contact number is important for any follow-up regarding the application.

10. Not providing the correct information about the fetal death, such as the date or location. Accurate details are essential for locating the record.

When navigating the process of obtaining a fetal death record in California, you may encounter several other forms and documents that are commonly used alongside the California VS 12 form. Understanding these documents can help streamline your experience and ensure that you have all necessary information at your fingertips. Below is a list of relevant forms and documents that may be beneficial to you.

• California VS 10 Form: This form is used to apply for a certified copy of a birth record. It requires similar information as the VS 12 form, including details about the individual and the applicant.
• California VS 11 Form: This document is utilized to request a certified copy of a death record. Applicants must provide personal information about the deceased and their relationship to the applicant.
• Certificate of No Public Record: Issued when a requested record cannot be found, this certificate serves as proof that the search was conducted. It is important to keep this document for your records.
• Application for a Marriage License: If you need to obtain a marriage record, this application is essential. It requires information about both parties intending to marry.
• Application for a Divorce Decree: This form is necessary when requesting a certified copy of a divorce record. It typically asks for details about the marriage and the parties involved.
• Request for Vital Records: This general request form can be used for various types of vital records, including birth, death, and marriage records. It simplifies the process by consolidating requests.
• Power of Attorney Form: If someone else is handling the request on your behalf, this document grants them the authority to do so. It must be signed by you to be valid.
• Identification Documents: Valid ID, such as a driver’s license or passport, is often required to verify the identity of the applicant when requesting records.
• Payment Authorization Form: This form allows you to authorize payment for the requested records, particularly if you are using a credit or debit card.
• Affidavit of Relationship: This document may be necessary if the applicant is not an immediate family member of the deceased. It outlines the relationship and may require notarization.

By familiarizing yourself with these forms and documents, you can better prepare for the process of obtaining fetal death records and other vital records in California. Each document plays a crucial role in ensuring that requests are processed smoothly and efficiently. Always remember to double-check that you have filled out all forms accurately to avoid delays.

The California VS 12 form is used to request certified copies of fetal death records. Several other documents share similar purposes or processes. Below is a list of five such documents, along with a brief explanation of how each is similar to the California VS 12 form.

• Death Certificate Application: Like the VS 12 form, this application is used to request a certified copy of a death certificate. It requires specific information about the deceased, including their name, date of death, and place of death, ensuring accurate record retrieval.
• Birth Certificate Application: This document is similar in that it requests vital records from the state. Applicants must provide personal information about the individual whose birth certificate is being requested, along with relevant details to help locate the record.
• Marriage Certificate Application: This application also involves the retrieval of vital records. It requires the names of the individuals involved, the date of marriage, and the location, paralleling the VS 12 form's need for specific identifying information.
• Divorce Decree Request: Similar to the VS 12 form, this request is made to obtain official documentation regarding a divorce. Applicants must provide identifying details about both parties and the date of the divorce to facilitate the search for the record.
• Genealogy Research Request: This document is used to obtain historical vital records for genealogical purposes. Like the VS 12 form, it requires specific information to locate records, emphasizing the importance of accurate details for successful retrieval.

When filling out the California Vs 12 form, it’s important to follow specific guidelines to ensure your application is processed smoothly. Here’s a list of things you should and shouldn’t do:

• Do complete a separate application for each fetal death record you are requesting.
• Do provide accurate and complete information in the Fetal Death Information section.
• Do include the correct fee of $18 for each copy requested.
• Do use a personal check or money order made payable to CDPH Vital Records.
• Don't send cash with your application, as it may be lost or misdirected.
• Don't leave any required fields blank; incomplete applications may delay processing.
• Don't forget to sign the application where indicated.
• Don't forget to mail your completed application to the correct address for processing.

Understanding the California VS 12 form is essential for anyone needing to request a certified copy of a fetal death record. However, there are several misconceptions that can lead to confusion. Here are four common misunderstandings:

• Misconception 1: The VS 12 form can be submitted online.

Many people believe that they can fill out and submit the California VS 12 form online. In reality, this form must be printed, filled out, and mailed to the California Department of Public Health. Online submissions are not accepted, so it is important to follow the mailing instructions carefully.

• Misconception 2: You can request multiple fetal death records on a single application.

It is a common mistake to think that you can request multiple fetal death records with one application. Each record requires a separate application. This means you need to complete a distinct form for each record you are seeking.

• Misconception 3: The fee is refundable if no record is found.

Some individuals assume that if the fetal death record cannot be located, the $18 fee will be refunded. Unfortunately, this is not the case. If no record is found, the fee is retained to cover the search costs, and a “Certificate of No Public Record” will be issued instead.

• Misconception 4: Any form of payment is acceptable.

It is a misunderstanding to think that cash payments can be sent with the application. The California Department of Public Health only accepts checks or money orders. Cash payments can be lost or misdirected, and the department will not be responsible for such losses.

When filling out and using the California VS 12 form, it is important to keep the following key points in mind:

• Separate Applications: Each fetal death record request requires a separate application. Ensure that you complete one form for each record you seek.
• Accurate Information: Fill out the Applicant Information section carefully. Provide all known details in the Fetal Death Information section to help locate the record.
• Fees Required: A fee of $18 is necessary for each copy requested. If no record is found, this fee will not be refunded, but a "Certificate of No Public Record" will be issued.
• Payment Methods: Payments should be made via personal check, postal money order, or bank money order. Do not send cash, as it cannot be tracked or refunded if lost.
• Mailing Instructions: Send the completed application along with the payment to the specified address for the California Department of Public Health Vital Records.
• Contact Information: If you have questions or need assistance, you can contact the department at the provided phone number.