Apostille Mail Request Cover Sheet

Complete and include this form with the three items below. Please type or print legibly.

1. A document signed by a California public official or an original notarized and/or certified document. Aphotocopy is not acceptable
2. A check or money order payable to Secretary of State in the amount of$20.00 per Apostille requested.Additional fees apply if the request is submitted in person.
3. A self-addressed envelope for the processed document to be returned. If you wish to use a mail trackingservice, please provide pre-paid postage. If you do not provide pre-paid postage, our office will return yourdocument via United States Postal Service regular mail

Note: If a birth or death certificate has the signature of a Health Officer or County Registrar (e.g. LocalRegistrar, Registrar of Vital Records), prior to presenting the document to our office for authentication, one of thefollowing will be required:

• Have that birth or death certificate certified by the county clerk’s office in the county in which it was issued; or
• Obtain a certified copy of that birth or death certificate from the county recorder or State of CaliforniaDepartment of Public Health