Codsiga Shahaadada Dhalshada
Codsiga Shahaadada Dhalshada
Buuxi foomkan si aad u dalbato nuqul sharciyeysan ee shahaadada dhalashada ee Minnesota.
Sharcigu wuxuu kaa doonayaa inaad bixiso macluumaad si aad u dalbato shahaadada dhalashada, Sharciyada Minnesota, qaybta 144.225, qaybta 7aad, iyo Xeerarka Minnesota, qaybta 4601.2600. Waxay ka soo horjeedaa sharciga si loo siiyo macluumaad been ah si loo helo shahaadada dhalashada. Waxaa dhici karta in lagugu ciqaabayo ganaaxyada, waqtiga xabsiga ama labadaba. Sharciyada Minnesota, qaybta 144.227 iyo qaybta 609.02, qayb-hoosaadka 3 iyo 4.
Macluumaadka lagu helayo diiwaankaa dhalashada ee la codsaday | |||||
Mawduuca | Magaca hore | Magaca dhexe | Magaca danbe | Soo gaabinta | |
Taariikhda Dhalashada (B/M/S) | ☐ Dhidig ☐ Lab | Magaalada Dhalashada | Wadanka dhalshada | ||
Waalidada | Magaca koobaad | Magaca dhexe | Magaca danbe | Magaca hore ee guurka 1aad | Soo gaabinta |
Magaca koobaad | Magaca dhexe | Magaca danbe | Magaca hore ee guurka 1aad | Soo gaabinta | |
Qofka buuxinaya codsigan - codsadaha | |||||
Magaca | Taariikhda Dhalashada (B/M/S) | Lambarka Maalintii (XXX-XXX-XXXX) | |||
Cinwaanka boostada - Waddada United Parcel Service (UPS) ma bixin doonaan sanduuqyada PO ama cinwaannada APO.) | #Qolka/waax da | Emailka | |||
Magaalada | Gobolka | ZIPka | |||
Macluumaadka ku saabsan shahaadooyinka dhalashada: Macluumaadka rikoodhka muhiimka ah ee Minnesota badankood waa macluumaad guud Marka diiwaanka uu yahay mid guud, macluumaadka iyo shahaadooyinka waxaa heli kara shakhsiyaadka buuxiya shuruudaha sharciga ee qodobada 1 - 19 xx xxxxx. Macluumaadka diiwaannada ee muhiimka ah waa qarsoodi. Macluumaadka ku saabsan dhalashada ilmo gabadha ah, oo aan isqabin aabaha ilmaha marka ilmuhu uuraysan yahay ama dhalanayo, waa qarsoodi ilaa hooyadu u fasaxdo marka dhalashada la diiwaan geliyo. Marka diiwaanka uu yahay qarsoodi, shahaadooyinka macluumaadka iyo dhalashada waxay xadidan yihiin kuwa ku qoran liiska qodobada 20 - 24. | |||||
XADGUDUB - Hubi sanduuqyada xxxxx xx ku tilmaamaya xiriirka aad la leedahay mawduuca diiwaanka: | |||||
Shahaadooyinka dhalashada xx xxx heli karo shakhsiyaadka buuxiya shuruudaha sharciga ah ee alaabada 1-19 xx xxxxx (Diiwaanka Dadweynaha) | |||||
1. ☐ Waalid lagu magacaabo mawduuca diiwaanka 2. ☐ Mawduuca Ayeeyo nimada 3. ☐ Mawduuca Awoow Wayn 4. ☐ Mawduuca Ilmaha 5. ☐ Mawduuca Ayeeyada 6. ☐ Mawduuca awoowga Wayn 7. ☐ Lamaanaha maadada (Waa inaad ahaataa xaaska / seyga hadda) 8. ☐ Mawduuca rikoodhka muhiimka ah (Waxaan codsanayaa diiwaankeyga dhalashadiisa) 9. ☐ Xisbi ka mas'uulka ah diiwaangelinta diiwaanka (guud ahaan xirfadle caafimaad ama uqaabilmaashaha umusha) 10. ☐ Mas'uulka sharciga ah, masuulka ama ilaaliyaha mawduuca (nuqulka rasmiga ah ee amar maxkamadeed oo magacaaga ku qoran) 11. ☐ Wakiilka daryeelka caafimaad ee maadada (awoodda daryeelka caafimaadka xx xxx baahan yahay qareen) 12. ☐ Wakiilka shakhsiyeed ee maadada; nuqul sharciyeysan ayaa loo baahan yahay si loo maamulo hantida 13. ☐ Guulaystaha mawduuca (mawduuca waa dhintay); nuqulka shahaadaysan ayaa loo baahan yahay si loo maamulo hantida 14. ☐ Go'aaminta ama ilaalinta xuquuqda shakhsi ahaaneed ama hantida iyo caddaynta shahaadada dhalashada loo baahan yahay 15. ☐ Wakaaladda ilmo-xannaanaynta - si loo dhameeyo baaritaanka kaddib-korsashada (Aqoonsi shaqaale ayaa loo baahan yahay) 16. ☐ Hay'ad Dawladeed ee gobolka / gobolka / federaalka (Aqoonsi shaqaale ayaa loo baahan yahay) 17. ☐ Qareen - lambarka Nambarka Aqoonsiga ee Minnesota waa: Liisanka AAN AHAYN Minnesota? Koobi nuqul ah 18. ☐ Iyadoo la raacayo nuqul sharciyeysan, xxxxx xxxxxxxxxxxx oo amarka amar maxkamadeed ee Maraykanku (ma aha shuruudo amar maxkamadeed) oo sii daaya shahaadada 19. ☐ Wakiil la oggol yahay oo ku qoran liistada 1-18 ee kor ku xusan (warqad saxeexan oo ka timid qofka oggolaanshaha sii deynaya ayaa loo baahan yahay) | |||||
Shahaadooyinka dhalashada ee la heli karo oo keliya shuruudaha ama kuwa hoos ku qoran (Diiwaanada Qarsoodiga ah) | |||||
20. ☐ Waalidka lagu magacaabo mawduuca mawduuca 21. ☐ Mas'uulka sharciga ah, masuulka ama ilaaliyaha mawduuca (nuqulka rasmiga ah ee amar maxkamadeed oo magacaaga ku qoran) 22. ☐ Mawduuca, marka 16 sano ama xx xxxx 23. ☐ Wakiilada barnaamijyada Minnesota oo maamula masruufka caruurta, gargaarka caafimaadka, MinnesotaCare, iyo adeegyada hoos yimaada Sharciyada Minnesota, qaybta 124D.23 iyo 626.556. (Aqoonsi shaqaale ayaa loo baahan yahay) |
24. ☐ Iyadoo la raacayo nuqul sharciyeysan, xxxxx xxxxxxxxxxxx oo amarka amar maxkamadeed ee Maraykanku (ma aha shuruudo amar
maxkamadeed) oo sii daaya shahaadada
Nuqulka Caddaynta Codsiga Shahaadada Dalashada
Buuxi foomkan si aad u dalbato nuqul sharciyeysan ee shahaadada dhalashada ee Minnesota
Qofka dhameystiraya codsigan - codsadaha: | |||
Saxiixa iyo Nootaayo (codsiga waa in lagu saxiixaa horjooge noorway haddii uu codsado boostada ama fakis) | |||
Waxaan cadeynayaa in macluumaadka ku qoran codsigan uu yahay mid sax ah oo dhameystiran sida ugu fiicneyd aqoonteyda. | |||
Saxeexa Codsadaha | Shaambada Nootariga/xxxxxx Notary Stamp/Seal | ||
Saxeexay ama qiray ka hor aniga: maalin ah , 20 Signed or attested before me on: day of | |||
Saxiixa dadweynaha Nootaayada Notary public signature | Mushqaayadayda way dahcaysaa My commission expires | ||
Macluumaadka Codsiga iyo Lacag bixinta | Codso | Kharashka | Wadarta |
Miyaad rabtaa inaad ku shaqeysid ciribtirka, ama Xxxxxxxx, ama labadaba? Dalbashada xxxx | |||
Xxx shahaadada dhalashada oo ay soo diraan First Class Mail®. | 1 | $26 | $26 |
Xxxxx xxxxxxxxxxxx dheeraad ah ayaad dooneysaa inaad ku iibsato diiwaankan dhalashada hadda? | $19 mid kasta | ||
• Waxaan doonayaa in wax laga qabto. (Looma diro Mail Class® haddii aan doorto gudbinta boogta xxxxx.) | $20 | ||
• Waxaan doonayaa in aan keeno buuq degdeg ah. (U soo diray Adeegga Qalabka ee United (UPS) Maalinta Maalinta Shaqada codsiyada ayaa lagu baaraandegayaa qaabka la helay haddii aan doorto kor-u-qaadista kore.) | $16 | ||
Si aad u gudbisid, calaamadee halkan ☐ inaad u baahan tahay saxiix. Xafiiska Diiwaanada Vital iyo UPS mas'uul kama aha dhalmada aan u baahnayn saxiix. UPS ma bixin doonaan sanduuqyada PO ama cinwaannada APO. | |||
OGAYSIISKA: Khidmadaha waa la bixin karaa wakhtiga codsiga oo aan dib loo soo xxxxx xxxxx. Sharciyada Minnesota, qaybta 144.226 | Lacagta wadarta: Qaddarka waa inuu ahaadaa ugu yaraan $26. | ||
Nooca Bixinta | ☐ Kaarka deynta MasterCard/VISA/Discover Ku qor macluumaadka kaararka xxxxx | ☐ Xisaabta # Jeega | ☐ Dalabaka lacagta Dalabaka lacagta # |
Lacagta loo diro Minnesota Department of Health waxaana loo diraa boostada Jeegaga lagu soo celiyo lacag la'aanta waxay ku dambeyn doontaa $ 30 oo lagaa rabo. Waxaad sidoo kale la kulmi kartaa ganaaxyo madani ah. Sharciyada Minnesota, qaybta 604.113, qaybta 2aad. | |||
Magaca kumbuyuutarka | Lambarka Kaarka | ||
3-god ee lambarka ammaanka | Taariikhda Dhicitaanka | ||
U dir codsiga iyo lacag bixinta Xafiiska Diiwaanada Vital ama Xafiiska Diiwaanka Vantaa County: Haddii aad qabtid su'aalo, fadlan la soo xiriir caafimaadka xxxxxx.xxxxxxxxxxxx@xxxxx.xx.xx ama wac 000-000-0000. | |||
Diiwaanada Muhiimka ah ee Xafiiska Arjiga Boostada iyo jeeg ama amar lacag ah si: Minnesota Department of Health Office of Vital Records PO Box 64499 St. Xxxx MN 55164-0499 XXXXX xxxxxxx iyo macluumaadka kaararka deynta: XXXXX – 000-000-0000 | Xafiisyada Diiwaanada Muhiimka ah xx Xxxxx Macluumaadka Xiriika Haddii aad arjigaan u soo gudbisid xafiiska diiwaangelinta ee muhiimka ah ee degmada, shaabad-raaciddu maaha mid ikhtiyaar ah. Dhammaan noocyada lacag bixinta lama aqbalayo. Wac xafiiska diiwaangelinta muhiimadda ee gobolka kahor intaadan soo gudbin codsigaaga si loo xaqiijiyo lacag bixinta iyo maraakiibta. |