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SCS Birth Certificate & ID Request Form

Please take a moment to fill out the form.

Birth Certificate Information
Birth Certificate Needed?
Florida ID Information
Florida ID Needed?
Is client homeless?
*We can supply Birth Certificates and/or IDs only if needed for one of the reasons below*
Reason for ID:

Please note: Regarding the FL ID, if client is homeless, the client may go to the DMV with a letter or affidavit from your agency confirming their homeless status. Second Chance Society endorses this approach in order to meet client needs.

I, the Case Manager, have referred the client above to Second Chance Society for their assistance. I acknowledge that the client has authorized me and my agency to periodically release information to Second Chance Society regarding the client’s birth certificate and/or ID needs for a period of up to one year from the date of award any goods or services from Second Chance Society to the client.

Once you click "SUBMIT", please wait for a confirmation to appear to ensure your application was successfully submitted.

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