BIRTH INDEX ORDER FORM

Type in the CITY and COUNTY you are requesting.

(NOTE: If you don't know the County, just type in the City name.)

Choose Index, Original, Supplimental or Both Choose Index or Supplimental Index Birth Index $35.00 Supplimental Index $35.00 Both Index and Supplimental $70.00

Year and Index Type Select the Year and Index you want 1963 $35.00 1964 $35.00 1965 $35.00 1966 $35.00 1967 $35.00 1968 $35.00 1970 $35.00 1973 $35.00 1976 $35.00 1977 $35.00 1978 $35.00 1979 $35.00 1963 Supplimental $35.00 1964 Supplimental $35.00 1965 Supplimental $35.00 1966 Supplimental $35.00 1967 Supplimental $35.00 1968 Supplimental $35.00 1970 Supplimental $35.00 1973 Supplimental $35.00 1976 Supplimental $35.00 1977 Supplimental $35.00 1978 Supplimental $35.00 1979 Supplimental $35.00

Date Requested Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Select Delivery Email Delivery (Monday-Friday) $FREE* US Mail (First Class) $1.00* Next Day Delivery (FedX) $19.95* Saturday Delivery $29.95*

Click PAYMENT when you are ready to check out.

         Fill-in your checking account information. Use the next check number in your check book.
        IMPORTANT!    Write VOID on the check you use.

Pay to the      Order of __________OHIO ADOPTEE SEARCHES_____________________ $      _______________________________________________________________Dollars      For ______________________                      This draft pre-authorized by accountholder

IMPORTANT: Billing address if different than SHIP TO address above (unless same as a previous order)
 

ChecksNet protects your personal and bank account information from theft or misuse by encoding and scrambling the data as it is transmitted from this website to us. By submitting this form, you hereby authorize Ohio Adoptee Searches to create a bank draft for the item(s) selected above. You further agree to pay a fifty dollar service charge if bank draft is returned unpaid by your bank.