Application for a Search and Certified Copy of a Vital Record
Non-Refundable Fees: $15.00 for certified copy, $6.00 for additional copies of same record,
$10.00 for non-certified (not a legal copy)
Applicant: Please fill in the information in the appropriate box for the requested record, the reason
for requesting the record, and the name and address for mailing the certified copy. Enclose a
check or money order payable to Treasurer, State of Maine and mail application to the address
above:
Birth
Record
Full Name of Child
Date of Birth
Place of Birth
Parent’s Full Name
Parent’s Full Name
Death
Record
Full Name of Decedent
Date of Death
Place of Death
Marriage
Record
Full Name of Groom/Spouse
Full Maiden Name of Bride/Spouse
Date of Marriage
Place of Marriage
Divorce
Record
Full Name of Husband/Spouse
Full Maiden Name of Wife/Spouse
Date of Divorce or Annulment
Place [Superior Court, County or District (Division)]
Please include a copy of a government issued ID and proof of relationship to the record requested or
proof of a direct and legitimate interest in the record. Please see our pamphlet regarding Direct and
Legitimate Interest - Accessing Closed Records in Maine.
Phone and online orders for Vital Records may also be placed through VITALCHEK, using a credit
card, at the toll free number 1-877-523-2659 or over the Internet at www.vitalchek.com.
Applicant’s signature: ________________________________________________________________
Applicant’s address: _________________________________________________________________
Phone number: ________________________________ Email:_______________________________
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Maine Center for Disease Control and Prevention (Maine CDC)
220 Capitol Street
11 State House Station
Augusta, Maine 04333-0011
(207) 287-3771
Fax: (207) 287-1093 TTY Users: Dial 711 (Maine Relay)
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