This is the City of San Juan’s printable form you fill out to request a certified copy of a birth or death record. It asks for the person’s and applicant’s personal details, relationship, and reason for the request, and lists the fees for the certificates, optional envelopes, and a record‑search charge. It also warns that providing false information can lead to a prison term of 10‑12 years and/or a fine up to $10,000.
| State certified birth certificate copy fee | $23.00 |
| State certified death certificate copy fee | $21.00 |
| Additional copy fee | $4.00 each |
| Record search fee | $10.00 |
| Poly envelope (letter size) fee | $4.00 |
| Poly envelope (legal size) fee | $4.00 |
| Vitals records envelope fee | $2.00 |
| Maximum penalty for false statement | Up to $10,000 fine and 10–12 years prison |