Form Dh-429 - Application For Amendment To Florida Birth Record Page 2

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INFORMATION AND INSTRUCTIONS FOR AMENDMENT TO BIRTH RECORD APPLICATION

Statute/Rule references may be accessed through the website address at the bottom of this form

FEES: The amendment-processing fee is nonrefundable, even if the amendment cannot be completed. In addition, it can only be applied to this

case and cannot be credited or transferred to another case.

ELIGIBILITY: Pursuant to s. 382.025, Florida Statutes, except for those births occurring over 100 years ago that are not under seal, birth certificates

are confidential and can be issued only to the registrant (the child named on the record) if of legal age (18), parent, guardian, or a legal representative of one

of these persons or by court order. Events occurring over 100 years ago not under seal are public record and available to anyone providing fee and application.

REQUIREMENT FOR ORDERING:

If applicant is self, parent or guardian, the applicant must provide a copy of valid photo identification.

If guardian, a copy of appointment order must also be included. If legal representative, your attorney Bar ID number and the name and a notation

of whom you represent must be included with your request. If not one of the above persons, you will need to complete and have notarized the

Affidavit to Release a Birth Certificate, DH Form 1958, and submit with this Application for Amendment to Florida Birth Certificate, DH Form 429,

or provide a court order. A release form is available from this office, most local vital statistics offices within the county health department and our

website. Website address located at bottom of this form.

TYPES OF AMENDMENTS:

A. An amendment resulting from a court ordered action:



Adoption

Legal Name Change

Paternity Establishment

(for assistance call (904)359-6900, ext.9001)

(for assistance call (904)359-6900, ext.9005)

(for assistance call (904)359-6900, ext.9004)

B. An amendment made administratively pursuant to vital statistics law (Chapter 382, F.S) and rule authority (Chapter 64V-1 F.A.C.)

(For

assistance call (904)359-6900, ext.9005)



Paternity Acknowledgement



Correction resulting from a misspelling or typographical error or omission



Correction of child’s name



Change to child’s name within 1 year of birth. Note: A legal change of name issued pursuant to s. 68.07(4), Florida Statutes, is required to change the

name after the 1

birthday UNLESS supporting documentation can be provided.

Putative Father:

This DH 429 form is not used for Putative Father related issues. For more information and assistance please visit our website below or call

(904)359-

6900, ext.9001.

Correction to a child’s name resulting from a misspelling or a typographical error can be made at any time after the child’s birth without supporting

documentation.

Omissions of child’s given name(s) may be made up to the child’s 7

birthday without supporting documentation.

Corrections to a child’s name (other than misspellings, typographical errors, or omissions) may be made only if documentary evidence supporting the

correction can be provided. In all cases, such changes to a minor child’s name will be made ONLY if both parents named on the birth record (if both are

named) are in agreement and sign the required affidavit before a notarizing official. If both parents are not in agreement or not available to sign, the name

can only be amended by a legal change of name (court order).

See s. 64V-1.002 and .003, Florida Administrative Code, for additional information defining our authority to make corrections to a birth record.

IMPORTANT: IF A NAME HAS BEEN CHANGED PREVIOUSLY ON THE BIRTH RECORD PURSUANT TO A COURT ORDER, I.E., BY ADOPTION,

PATERNITY ACTION OR LEGAL NAME CHANGE, IT CAN ONLY BE CHANGED SUBSEQUENTLY THROUGH ANOTHER COURT ORDER.

RESPONSE TIME:

Response time for processing an amendment varies depending upon our workload at the time your request is received. Generally,

an amendment is completed within two to three weeks. RUSH processing is available for those who need assurance of faster service. Orders received in an

envelope marked RUSH and with the $10.00 RUSH fee will be given priority over other pending work; however, no amended certificate can be issued until

all required evidence, forms, applicable fees and appropriate signatures have been received and meet the criteria as established by law or in rules of the

department.

MAIL THIS APPLICATION WITH PAYMENT TO

DEPARTMENT OF HEALTH

OFFICE OF VITAL STATISTICS

ATTN: CORRECTION UNIT

P.O. BOX 210,

Jacksonville, FL 32231-0042

(Street Address: 1217 North Pearl Street, Jacksonville, Florida, 32202)

PLEASE VISIT OUR WEBSITE:

DH 429, 04/2016, Florida Administrative Code 64V-1.002 (Obsoletes Previous Editions)