<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.sda94c26a-eb5a-48c3-97a8-741191186656Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; vertical-align: baseline; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000000 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sda94c26a-eb5a-48c3-97a8-741191186656000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000003 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Rules?Rule=44:09:06:04"><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000000">44:09:06:04</span></a><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000001">.  Application form requirements.</span><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont"> To request a certified or informational copy of a vital record, the applicant shall provide the following information on an application form prescribed by the Department of Health or via a method that allows for authentication of the applicant:</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656000002"> </span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (1)  Applicant's full name;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (2)  Applicant's current home or business address;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (3)  Signature of the applicant or electronic authentication;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (4)  Applicant's current telephone number, if applicable;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (5)  Type of vital record requested;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (6)  For a certified copy only, a statement or evidence of the relationship of the applicant to the registrant;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (7)  For a birth record only, the name of the registrant on the record, the registrant's date of birth, and the mother's maiden name, or enough information to locate the record;</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (8)  For a death record, the name of the registrant on the record and the date of death, or enough information to locate the record; and</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    (9)  For a marriage or divorce record, the names of both parties on the record and the date of event, or enough information to locate the record.</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656000002"> </span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    </span><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000001">Source:</span><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont"> 31 SDR 213, effective July 4, 2005; 53 SDR 56, effective November 5, 2026.</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    </span><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000001">General Authority:</span><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-25-52.4"><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000003">34-25-52.4</span></a><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">.</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">    </span><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000001">Law Implemented:</span><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=34-25-52.4"><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont-000003">34-25-52.4</span></a><span class="sda94c26a-eb5a-48c3-97a8-741191186656DefaultParagraphFont">.</span></p><p dir="ltr" class="sda94c26a-eb5a-48c3-97a8-741191186656Normal"><span xml:space="preserve" class="sda94c26a-eb5a-48c3-97a8-741191186656000002"> </span></p></div></body></html>