Fillable dhs birth certificate form

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DEPARTMENT OF HEALTH SERVICES Division of Public Health F-05291 (Rev. 12/11) STATE OF WISCONSIN Chapter 69.21 Wis.Stats. Page 1 of 2 WISCONSIN BIRTH CERTIFICATE APPLICATION (for Mail or In-Person Requests) TYPE or PRINT. PENALTIES: Any person who wilfully and knowingly makes a false application for a birth certificate is guilty of a Class I felony [a fine of not more than $10,000 or imprisonment of not more than 3 years and 6 months, or both, per s. 69.24(1)]. Any person who wilfully and knowingly
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dhs birth certificate
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