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Correcting a Birth Certificate DEPARTMENT OF HEALTH AND (City of New York)

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DEPARTMENT OF HEALTH AND MENTAL HYGIENE • OFFICE OF VITAL RECORDS
Correcting a
Birth Certificate
Who Can Apply for a Correction?
How Do I Make a Correction?
What Kind of Document Do I Need?
l
The person named on the certificate if he/she is at least 18 years old.
l
Parents or legal guardians of the person less than 18 years of age named on the certificate.
Anyone applying must submit current (not expired), signed photo identification. If both parents’ names appear on the
record, both
must sign application and submit photocopy of each parent’s identification. We accept photocopies of
identification with mailed applications. Photocopies must be clear and include front and back of identification.
If the hospital where your child was born made a mistake on the birth certificate, you must submit your application and the
newborn certificate you received to the hospital if the child is less than 1 year of age.
l
Submit original documents (for example, a marriage record or a religious document) on official letterhead or
with an original seal depending on the kind of correction you want (photocopies, altered documents or notarized
copies are not accepted). See Box 1 on Page 2.
l
Submit one photocopy with each of the original documents.
l
Complete and sign the application.
l
Pay a non-refundable $40 processing fee for most corrections plus $15 per copy for each new certificate.
l
If you are applying by mail, include a self addressed, stamped envelope so that we can return your documents.
You must send original documentation on letterhead or certified copies with your application. Certified copies are documents
issued by a government office that has a raised seal, like birth certificates or marriage certificates. Usually a fee is required to
obtain a certified copy from an office or agency.
Notarized copies, photocopies or altered documents are unacceptable.
Generally, a document must have been established prior to the child’s 7
th
birthday or it must be at least 10 years old.
This helps us establish that the documentation you are submitting is legitimate. Documents should include the following:
l
Child’s Name
l
Listed Date of Birth
l
Parent’s Name(s)
If your documents are in a language other than English, you must obtain an official translation of documents needed.
Foreign consulates often will translate official documents for you. We also accept translations from established translation
services. If you can’t provide the required documents, ask for help by calling 311.
VR 172 (Rev. 01/15)
- 1 -
Application Fee Applies:
1. Adding a child’s given name by family more than 60
days after birth.
2. Family’s errors and omissions, except adding a given
name within 60 days of birth.
3. Hospital and licensed midwife errors and omissions
after 12 months.
4. Adoptions (Court Order).
5. Correct gender marker on birth certificate.
6. Re-submitting an application more than 1 year after
rejection.
The Health Department charges a non-refundable $40 application processing fee to make most corrections. Where
fees apply, the application is only $40 even if more than one item is corrected.
Birth Certificate Corrections
FEES: How Much Does It Cost to Make a Correction?
No Fee
Applies:
1. Acknowledgments of Paternity.
2. Orders of Filiation/Order of Paternity.
3.
Adding a parent who was married prior to the birth of the child.
4. Adding a child’s given name.
a. If submitted by family within 60 days of birth to the
Health Department.
b. If submitted by family to the hospital within 12 months
of date of birth.
5. Correcting hospital errors and omissions.
a.
If submitted by the hospital of birth within 12 months
of birth.
6. If applying for Delayed Registration of Birth use form VR34 .
Register to vote: http://www.nyccfb.info/public/VRC/registeringToVote.aspx?sm=public_rtv
Box #2: List of Documents Accepted by the New York City Health Department
How Do I Add the Name of Another Parent? Look below to see which description fits your situation.
I Want To . . . (please check all that appl y)
Where fees apply, the application is only $40 even if more than one item is corrected.
□
Add child’s first and middle name BEFORE child’s 1
st
birthday at the hospital of birth. No Fee No Documentation Required
□
Add a child’s first and middle name BEFORE 60 days of birth at DOHMH. No Fee No Documentation Required
□
Correct an error or omission made by the hospital after child’s 1
st
birthday 2
□
Correct child’s first or middle name, or add a child’s middle name BEFORE child’s 1
st
birthday
1, 3, 4, 5, 7 or 8
Example: Dabid to David
□
Child less than 1 year
No Documentation Required
□
Child over 1 year
1, 3, 4, 5, 6, 7 or 8
□
Correct spelling of child’s last name (all documents must be dated PRIOR to birth of child) 10, 11, 12 or 13
□
Correct child’s date of birth or sex 2
□
Correct spelling of parent’s information 9, 11 or 16
□
Add name of another parent. Fee may apply. See fee section on bottom of page 1. See Box 3 below
□
Legal name change 12 with a name change
Example: June to Edna petition or 14
□
Remove information from birth record 15
□
Correct gender marker on birth certificate
Go to nyc.gov/vitalrecords for
documentation required or call 311
You will need one of the
documents below:
(see box 2)
Box #1: Document List
□
Correct first or middle name after 1
st
birthday.
1, 3, 4, 5, 6, 7 or 8
□
Correct a hospital error before 1
st
birthday (Please return application to hospital of birth) No Documentation Required
□
Add a child’s first and middle name AFTER 60 days of birth.
- 2 -
Box #3: Adding Another Parent’s Name
Adding the name of another parent to a birth certificate, typically the father, depends on the marital status of the mother.
Married same sex parents also can add their names to birth certificates. See table below to find out what you must do.
Marriage records or other documents must be submitted with the application. In cases where the parent has
been married more than once, divorce records also must be submitted.
New York State recognizes same sex marriage performed in other states, Washington DC and abroad. It does not
recognize common law marriage.
Marital Status of Parent You Need To:
Mother married during pregnancy, want to add spouse’s name If you were married at the time of your child’s birth,
(male or female) complete Section 4 on page 4 of the application
Mother not married during pregnancy but now married to Complete an Acknowledgment of Paternity form (DSS 4418)
biological father or go to Family Court for an Order of Filiation
Mother not married during pregnancy and not married now Complete an Acknowledgment of Paternity Form (DSS 4418)
and wants to add a father or go to Family Court for an Order of Filiation
Same Sex Parents (Female) not married Go to Family or Supreme Court for an Order of Adoption
Same Sex Parents (Male) married or not married Go to Family or Supreme Court for an Order of Adoption
Acknowledgment of Paternity Forms (LDSS 4418) are available in the Corrections Department lobby and enclosed with all
applications ordered by mail or go to https://www.childsupport.ny.gov/dcse/pdfs/4418.pdf
Mother married after birth but not to biological father Go to Family or Supreme Court for an Order of Adoption
Mother married to a male during pregnancy but not to biological father
Go to Family Court for an Order of Filiation
1. Letter from hospital where child was born including child’s
correct name, date of birth, and parent’s name(s).
2. Letter from hospital admitting error.
3. Immunization record showing child’s name, date of birth, parent
name and the health care facility’s stamp.
4. First census record taken after birth or census taken at least
10 years ago (federal or state).
5. Letter from physician including treatment dates.
6. School admission letter including date of admission.
7. Religious document.
8. Child’s life insurance policy.
9.
Parent’s birth certificate (for corrections of child’s last name, the
certificate of the parent who has the child’s last name is required).
10. Parent’s passport.
11.
Parent’s marriage record if parents were married before child’s
birth, last name corrections only (New York State does not
recognize common law marriage).
12. Parent’s naturalization certificate.
13. Birth certificate of an older brother or sister.
14.
Certified Court Order
which must include Date of Birth, Place of
Birth and Certificate Number.
You must go to Civil Court if you live
in NYC. Outside of NYC go to the appropriate court for this action.
15. Usually requires a State Supreme Court Order unless the
hospital of birth made a mistake. If hospital made the error
request an admission in writing from the hospital.
16. Parent’s birth record, older child’s birth record, religious
document or naturalization certificate. Marriage Record may
be used for last name only.
List items to be corrected
Please use one line per correction. We cannot accept white-outs or cross-outs; if you make a mistake, please use a new
application form.
Write errors as they appear on birth record
What should it say on birth record?
Example: Child’s First Name
Example: Date of Birth
Not Shown
October 16, 2009
Michael
October 19, 2009
DEPARTMENT OF HEALTH AND MENTAL HYGIENE • OFFICE OF VITAL RECORDS
Birth Certificate Correction Application Form
Reference
No.
VR 172 (Rev. 01/15)
Please use blue or black ink ONLY.
–
Telephone
Number
Wireless
Carrier
Email
Address
First Name Middle Name
Last Name
Apartment Number
ZIP CodeStateCity
Home
Area Code
Telephone Number
–
Cell
Area Code Telephone Number
–
Daytime
Area Code Telephone Number
Mailing Address
Marital
Partnership
Status
□
Single
□
Divorced
□
Married
□
Widowed
□
Separated
□
Domestic Partnership
Name on Birth Certificate as it now appears
Birth Certificate Number
Date of Birth
Sex
First Name Middle Name
Month Day Year
□
Male
□
Female
Last Name
Mother’s Maiden Name
First Last
– –
/
/
Place of Birth
Name of Hospital, birthing center or if born at home, street address, city, state, ZIP)
Section 1: What Is Your Name? You Must Be At Least 18 Years Old
Section 2: Birth Certificate Information
Section 3: What Do You Want To Correct?
156
□
AT & T
□
T-Mobile
□
Sprint
□
Verizon
□
Other
_______________________________________
- 3 -
This is to certify that I have examined the original record that this application seeks to correct, and any original
documents required to verify the correction. There are no omissions or apparent errors in the original record that have
not been covered. Therefore, the application is approved.
Signature of Deputy City Registrar Date
Your Signature (if you are 18 or older and are requesting a correction of your own birth certificate)
Signature of Mother/Parent/Legal Guardian
Signature of Father/Parent/Legal Guardian
Signature of Self
Date
Date
Date
Warning! No person shall make a false, untrue or misleading statement or forge the signature of another on an application required to be prepared pursuant
to the New York City Health Code. A violation of the Health Code shall be punishable as a misdemeanor.
(NYC HEALTH CODE 3.19)
DOCUMENT
NO.
If you want to add the name of another parent, please fill out this section. You must have been married prior to the birth of
the child. See “How Do I Add the Name of Another Parent?” on page 2.
Please sign the form where appropriate. If both parents’ names appear on the birth certificate, both must sign if the
child is under 18.
Second Parent’s
Date of Birth
Second Parent’s Age
at Time of Child’s Birth
Sex
Month Day Year
□
Male
□
Female
/
/
First Name Middle Name Last Name of Second Parent
Child’s Last Name (as it will appear on the certificate
even if it will remain the same)
Signature of Second Parent Date
Parent’s Country of Birth
How to Submit Your Application:
A copy of the corrected certificate costs $15. This fee is waived if you enclose a certified copy of a certificate purchased
within the past 3 months and want to exchange it for a corrected certificate.
Figure out the cost: Processing Fee: $40 (See page 1 for applicable fees. $
_________
( not all corrections have a fee.)
Copy Fee: number of copies
_________
X $15 each $
_________
Total Amount Enclosed: $
_________
Please make your check or money order payable to the:
New York City Department of Health and Mental Hygiene.
Cash not accepted. Walk-in customers may pay using a credit or debit card.
Make certain you have enclosed everything necessary (please check all that apply):
□
Completed, signed application with a copy of photo
□
One photocopy of each original or certified copy
identification for each parent named on birth record
□
Payment if applicable
□
Original or certified documents
□
If mailing, self-addressed, stamped envelope.
Submitting false identification is a crime and violators are subject to prosecution.
MAIL TO: NYC Department of Health and Mental Hygiene
Corrections Unit
125 Worth Street, Room 144, CN-4
New York, NY 10013
VR 172 (Rev. 01/15)
Section 4: Second Parent Information
Section 5: Sign Your Application
Certification by the NYC Department of Health and Mental Hygiene
Name of Second Parent
- 4 -
FOR HEALTH DEPARTMENT USE ONLY
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Correcting a Birth Certificate DEPARTMENT OF HEALTH AND (City of New York)

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Completed 20 February 2021

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