USGenWeb Archives Project - West Virginia

Record Submission Forms

Documents placed in the USGenWeb Archives remain the property of the contributor, the contributor gives permission to the
USGenWeb Archives to store the file permanently for free access. Click Here for Information on Copyright and here USGenweb Copyright

***NOTE***
These forms are for genealogical and historical records only.
DO NOT ENTER ANY INFORMATION ON LIVING INDIVIDUALS. IT WILL NOT BE POSTED
Please transcribe the full record, if you do not have the full record or all the facts required, please do not use this form.
West Virginia USGenWeb Archives Birth Certificates
Click here for information about these forms. (Opens a New Browser)
Use this form to automatically create and send your ancestors birth records to the West Virginia USGenWeb Archives
formatted for acceptance in the USGenWeb Archives Project. Or you can send your file by email to the
Archives Manager for your county (Addresses below)
An asterisk {*} next to a field means it is required, please double check before submitting.
Your tab key will work to move between the fields.

Your Email Address:	*
Your First Name-Submitter:	*	Your Last Name-Submitter:	*

Name (First, Middle)

Last Name

Date Of Birth:
Month:	Day:	Year: *
Time Of Birth

Place Of Birth:

County Of Birth:	*
Gender:		Race

Parent's Residence:
Mothers Name (First Middle)		Mothers Maiden Name
Age:

Mother's Place Of Birth:

Fathers Name (First Middle)		Fathers Last Name
Age:

Father's Place Of Birth

Name Of Hospital:

Name of Doctor:

Source Of Record: *

Certificate No:

Any Other Information On Record Enter Below:

Enter Any Additional Comments:

**County or Counties Where File is to be Posted:**
*Required*

If you want a copy of this sent to your email check here:

(Before you submit please note, we can not provide you with records, if you are looking for a record please click here.
These forms are for sharing records which you already have in your possession.)

[ West Virginia USGenWeb Archives Table of Contents ]

West Virginia USGenWeb Archives File Managers Are:

Debra Crosby (Temporary File Manager) All Counties

Record Submission Forms For Other States
Record Submission Forms For Other States Mirror Site
Record Submission Forms For Other States Mirror Site

Problems or Comments with the forms contact Debra Crosby
Created by David Crosby © Copyright 2002 - Present