Milwaukee County Form for Free Birth Certificate

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All That Philly Jazz

News & Politics Business

Milwaukee County Register of Deeds

Request for a Free Birth Record needed to Obtain an
I.D. Card for Purposes of Voting

YOUR Name (Please Print)
BIRTH RECORD
INFORMATION

YOUR Street Address Apt. No.

City / State / Zip

I hereby request one birth certificate at no cost for the purpose of obtaining
an operator’s license* or an identification card** for purposes of voting.

I attest (declare) that I have not previously received a state issued
identification and have not previously received a free birth record from the
Milwaukee County Register of Deeds.

___________________________________ _____/_____ /2012
Signature (of person named on birth record) Date

*Issued under Chapter 343 of the state statutes
**Issued under section 343.50 of the statutes

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