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NEW JERSEY VITAL RECORD REQUEST FORM:
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BIRTH

Name of Child

Date of Birth or years to be searched
County
City
Fathers Name
                     (first middle last)
Mothers Name
                     (first middle last)
   


MARRIAGE

Husband Name

                     (first middle last)
Wife Name
                     (first middle last)
Date of Marriage or years to be searched
County
City
   


DEATH
Name
                     (first middle last)
Date of Death or years to be searched
County
City
Father's Name
                     (first middle last)
Mother's Name
                     (first middle last)
Social Security #
   


OTHER NJ Vital Record
Name
                     (first middle last)
Type of Record Requested
Date of Event or years to be searched
County
City
   

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