180 S. Main St., Ste. 252, Martinsville, IN 46151
Online: Credit or debit card via the GovPay website:
***Please note: When paying online, you MUST include a copy of the receipt from GovPay with your application forms.
For Office Use Only (Begin at #1):
Morgan County Health Department
180 S. Main St., Ste. 252
Martinsville, IN 46151
WARNING: False applications, altering, mutilating or counterfeiting Indiana birth certificates is a criminal offense under IC 16-1-19-6.
By checking the box below, I hereby certify that I am the requestor named above and that I am authorized to request a certified copy of the record for the above named individual, in accordance with Indiana Code 16-37 and 410 Indiana Administrative Code 18. I understand that penalties are described by law for misrepresentation on this request.
A Birth Certificate set costs $15.00 each (online). This includes both a full and a wallet size certificate. You may purchase vinyl covers in full and/or wallet size for $2.00 each. Please indicate your choices and quantities below.
*** I.D. required. Please provide 1 form of identification. ***
If you would like the certificate mailed somewhere other than the above address, please print name and address of the person to whom the certificate is to be mailed: