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APPLICATION TO AMEND A MARRIAGE RECORD
TYPE OR PRINT CLEARLY IN BLACK INK ONLY
NO ERASURES, WHITEOUTS, PHOTOCOPIES, OR ALTERATIONS
If an acceptable application to amend the record is registered within one year of the date of the event, there is no processing fee; however,
there is a fee required for a certified copy.
Enclosed is the fee of $__________ for a certified copy of the newly amended record.
* * *
If an acceptable application to amend the record is registered one year or more after the date of the event, there is a fee for filing the
affidavit, which includes one certified copy. There is a fee for each additional certified copy. Please contact your County Recorder, County
Clerk, or the State Registrar for the current fee, or visit our website at www.cdph.ca.gov.
Enclosed is the fee of $__________ for filing the affidavit and one certified copy of the newly amended record.
Enclosed is the fee of $__________ for each additional certified copy of the newly amended record.
_____________________________________________ _____________________________________________________________
Printed Name of Applicant Mailing Address of Applicant
Phone (
) ___________________________ ______________________________________________________________________
City State ZIP Code
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE FORM
1. The original marriage certificate cannot be altered. Corrections are made by completing an Affidavit to Amend a Marriage Record
(VS 24C). This form becomes a part of the original record—type or print clearly in black ink only. Your certified copy will
include a copy of the original certificate with a copy of this form attached. Both documents must remain together for the certified copy
to be valid.
2. Check the type of record to be corrected: Public, Confidential, Declared, or Non-Clergy.
3. Complete Part I, Items 1A–4D with the information as it appears on the original certificate.
4. Enter the certificate item number(s) to be corrected, either from the original or subsequent amendment, in Part II—Item 5 (Item number
to be corrected). List one item per line.
5. Enter the incorrect information as it appears on the original certificate in the line(s) provided below Item 6 (Incorrect Information That
Appears on Original Certificate). In Item 7, enter the corrected information as it should appear for each item listed in Item 6.
6. Enter the reason for the correction(s) in Item 8.
7. Read the affidavit statement. Two persons who are certifying to the statement of corrections must sign in Items 9A and 10A.
8. If changing the date or place of marriage, the person who performed the marriage must sign the affidavit as one of the supporting
affiants. The VS 24C cannot be used to change the identity of either party to the marriage.
9. Do not write in Items 11 or 12. This space is reserved for State or Local Registrar use only.
10. When properly completed and signed by two parties, return the form to either the State or Local Registrar, with a check or money order
payable to the Office of Vital Records. The address of the Office of Vital Records is:
California Department of Public Health
Office of Vital Records, MS 5103
P.O. Box 997410
Sacramento, CA 95899-7410
11. This form cannot be used to change, add, or amend the new name fields on the marriage certificate.
NOTE: For Confidential marriage records, the form and the fee, if applicable, must be sent directly to the County Clerk in the
county where the marriage was performed. Certified copies of Confidential Marriage records may ONLY be obtained from the
County Clerk’s Office.
For Public, Declared, and Non-Clergy marriage records, a certified copy of both the original certificate and the amendment form
may be obtained from the County Recorder in the county where the license was issued, or from the State Registrar.
For Official Use Only
STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, OFFICE OF VITAL RECORDS VS 24C (01/01/2010)
