Mail Request to:
Waltham City Clerk Office
610 Main Street
Waltham MA 02452
Date: __________
Type of record's) and number of copies:
Birth____________ Death __________ Marriage___________
Please Print
Name's) Date's)
_____________________________________ _______________________________
______________________________________ _______________________________
_____________________________________ _______________________________
Pricing: $10.00 Fee for long form certificates (birth certificate will be sufficient for travel)
$15.00 (per hour) Fee for detailed search (i.e. genealogy - certified copy included, if found).
Other: _________________________________________________________________
Please submit your request along with proper fees (cash or check only)
Checks can be made payable to the City of Waltham
Please enclose a self-addressed, stamped envelope with this form in order to ensure a rapid response
Impounded Records
A birth record is considered impounded if the parents were not married at the time of the birth. A marriage record is considered impounded if there is a parent’s name missing on the certificate. Therefore, these records can only be acquired by an individual whose name appears on the (certificate's).
If trying to obtain an impounded record, you must provide a picture ID (if coming in person), or have your signature notarized on this request form. The state law regarding impounded records is explained below:
Massachusetts General Law - CHAPTER 46. RETURN AND REGISTRY OF BIRTHS, MARRIAGES AND DEATHS
Chapter 46: Section 2A Disclosure of information about vital statistics; conditions
Section 2A. Examination of records and returns of children born out of wedlock or abnormal sex births, or fetal deaths, or of the notices of intention of marriage and marriage records in cases where a physician's certificate has been filed under the provisions of section twenty A of chapter two hundred and seven, or those of persons born out of wedlock, or of copies of such records in the department of public health, shall not be permitted except upon proper judicial order, or upon request of a person seeking his own birth or marriage record, or his attorney, parent, guardian, or conservator, or a person whose official duties, in the opinion of the town clerk or the commissioner of public health, as the case may be, entitle him to the information contained therein, nor shall certified copies thereof be furnished except upon such order, or the request of such person. The provisions of this section shall not apply to such records, returns or notices recorded or filed prior to January first, eighteen hundred and forty-one or to such copies thereof.