Application for Certificate of Birth Resulting in Stillbirth - Nebraska 2026

1. Click ‘Get Form’ to open the Application for Certificate of Birth Resulting in Stillbirth in the editor.
2. Begin by entering the full name of the child in the designated field. Ensure accuracy as this is a vital record.
3. Next, input the month, day, and year of stillbirth. This information is crucial for record-keeping.
4. Fill in the city or town and county where the stillbirth occurred. This helps local authorities track records accurately.
5. Provide both parents' full names. The father/parent’s name should be entered first, followed by the mother/parent’s name at birth.
6. Indicate the purpose for which this record will be used. This section may require thoughtful consideration based on your needs.
7. Clarify your relationship to the person listed on the record to validate your request.
8. Sign and print your name at the bottom of the form, along with your address, telephone number, email address, and today’s date.
9. Remember to enclose a photocopy of your photo ID when mailing in this request to ensure processing.

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