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VS62/06 COMMONWEALTH OF VIRGINIA Application for Certification of a Vital Record Virginia statutes require a fee of $12.00 be charged for each certification of a vital record or for a search of the
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Name of requesterdaytime phone is the name and phone number of the person requesting information or services.
Anyone requesting information or services that requires a way to contact them during the daytime.
Simply write down your name and daytime phone number in the designated area on the form.
The purpose is to provide a way for the requester to be contacted during business hours if needed.
Name of the requester and their daytime phone number.
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