Vital Record Request Form

Thank you for choosing Leaf River Genealogy to assist you with obtaining your vital records.

This form is designed to collect the information needed to request official records such as birth, marriage, death, divorce, military, naturalization, and other public records. Please complete the form as accurately and thoroughly as possible. The information you provide will help ensure your request is prepared correctly and reduce the likelihood of delays.

Please Note:

• Completing this form does not submit a request to a government agency.

• Government agencies may require additional documentation, proof of identity, or proof of eligibility before a record can be issued.

• Please do not include credit card or payment information in this form. If payment is required, we will complete that step together through the issuing agency's secure website or discuss secure payment options during your appointment.

• Your personal information will be treated as confidential and used solely for the purpose of assisting with your record request.