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VITAL RECORDS

 Court Order Delayed Certificate of Fetal Death

A Court Order Delayed Registration of Fetal Death VS 105 (PDF) form is utilized to register a fetal death certificate when:

  • A fetal death record was never registered or is not on file with the State Registrar

For additional information please see the informational pamphlet: 


Supporting Documents 

Supporting documents are used to support the information being amended.  Required documents include the following:

  • Certified Order Establishing Fact of Fetal Death (top of VS 105 form)
  • Court Order Delayed Registration of Fetal Death (bottom of VS 105 form)

A certified court order is required when submitting a Court Order Delayed Registration of Fetal Death.  


Sworn Statement

A notarized Sworn Statement, completed by an authorized person, is required to receive a certified authorized copy of the amended certificate.  Please visit the Authorized Copy vs. Informational Copy webpage for a list of authorized persons.


Certified Court Order 

A “certified” copy of the court order must be a copy of the order that was originally prepared by the court and signed by the judge.  It cannot be an original printout.  The photocopy you receive from the court must have all of the following:

  • An original court seal
  • A signature (or signature stamp) of the judge
  • An original signature (or signature stamp) of the court clerk


Amendment Fees

  • Court Order Delayed Registration of Fetal Death requires a twenty-three dollar ($23) registration fee, which includes a certified copy of the fetal death certificate
  • Additional copies are eighteen dollars ($18) each


Processing Times

CDPH-VR processing times may occasionally increase as do the volume of requests.  

Currently Court Order Delayed Registration of Fetal Deaths are processed within ten (10) to twelve (12) weeks from the date CDPH-VR receives the request.


Helpful Tips

  • Complete all documents in black ink
  • No erasures, alterations or whiteouts are allowed on the form once it has been certified
  • This form will assist in creating the new birth certificate  


Helpful Links 

Court Order Delayed Registration of Fetal Death VS 105 (PDF) form

Amendment Sworn Statements (English) (Spanish)

Court Order Delayed (PDF) pamphlet

(Español) Certificados Retrasados por Orden Judicial (PDF)

Directory of County Vital Record Offices


Other Amendment Types

General Birth Amendment

Court Order Name Change

Correcting a Sex Field Error

Sex Change/Reassignment

Adoption

Acknowledgement of Paternity/Parentage

Adjudication of Facts of Parentage

Supplemental Name Report

Death/Fetal Death

Marriage


Delayed and Court Order Delayed Vital Event Types

Delayed Registration of Birth

Court Order Delayed Registration of Birth

Court Order Delayed Registration of Marriage

Court Order Delayed Registration of Death


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