AMENDMENT PACKET FOR ALABAMA BIRTH AND DEATH CERTIFICATES

This packet provides information to begin the process of changing or correcting an Alabama
birth or death certificate. In most cases, additional documentation or a court order will be
required.

Birth Certificates
 Amendments (Changing/Correcting a Birth Certificate) – Application 1

Information on a birth certificate entered in error when the birth certificate was originally prepared may be
corrected through an amendment process as specified by law. Legal documentation or court action
may be required to process the amendment.

The fee to amend a birth certificate is $20.00 which includes one certified copy of the amended birth
certificate. Additional copies of the same record ordered at the same time are $6.00 each. There is an
additional fee of $15.00 to expedite a request.

 Legitimations (Adding the Father to a Child’s Birth Certificate) – Application 2

Legitimations establish the legal father of a child, allow the father’s name to be added to a child’s birth
certificate, and in some cases allow the child’s name to be changed. The following four (4) legitimation
methods are legal procedures and can be used only if legal requirements are met. Documentation in
addition to the attached application will be required to change a birth record through any
legitimation process.
1. Probate Court Legitimations are processed by the Probate Courts.
2. Legitimations through Marriage are processed by the Center for Health Statistics.
3. Acknowledgments of Paternity are processed by the County Department of Human Resources or the
Center for Health Statistics.
4. Paternity Determinations are processed by the Circuit Courts (Juvenile Division) under the Uniform
Parentage Act. Note: In some cases, a court determination can remove a father from a child’s birth
certificate.

The fee to prepare the new birth certificate following legitimation is $25.00 which includes one certified
copy of the new birth certificate. Additional copies of the same record ordered at the same time are $6.00
each. There is an additional fee of $15.00 to expedite a request.

 Adoptions – Application 3

When an adoption is finalized in court, information on the birth certificate, such as the child’s name and the
parents’ names, can be changed. Court documentation in addition to the attached application will be
required to change a birth record after an adoption occurs.

The fee to prepare the new birth certificate following adoption is $25.00 which includes one certified copy of
the new birth certificate. Additional copies of the same record ordered at the same time are $6.00 each.
There is an additional fee of $15.00 to expedite a request.

To request a birth amendment or a new birth certificate following legitimation or adoption, complete the
appropriate application provided in this packet and indicate the specific changes to be made to the birth
certificate. Mail the completed application with valid identification and the appropriate fee to:
Center for Health Statistics
Special Services Division
P.O. Box 5625
Montgomery, Alabama 36103-5625
If you have any questions regarding changes to a birth certificate, call 334.206.2637.

ADPH-HS-33/Rev. 05/01/2019
Death Certificates

 Changes/Corrections to the Personal/Demographic Information – Application 1

Personal/demographic information may be corrected through the amendment process by the funeral
home, the informant, an immediate family member listed on the record or others with an appropriate legal
interest. The “Application to Change an Alabama Birth or Death Certificate” should be completed,
indicating the changes to be made to the death certificate. Legal documentation or court action may be
required to process the amendment. The original information on the death certificate will not be
changed. The amendment will be an affidavit issued with the original certificate indicating the
items which were corrected.

The fee to amend a death certificate is $20.00 which includes one certified copy of the certificate.
Additional copies of the same record ordered at the same time are $6.00 each. There is an additional fee
of $15.00 to expedite a request. Mail the completed application referenced above with valid identification
and the appropriate fee to the address provided in item #3 below.

 Changes/Corrections to the Medical Certification Information; the Date of

Death/Pronouncement; and/or Time of Death/Pronouncement

Only the certifier (physician, certified registered nurse practitioner, certified nurse midwife, coroner or
medical examiner) who signed the death certificate may make changes/corrections to this information on
the death certificate. The application referenced above cannot be used to request
changes/corrections to these items. However, instructions for requesting these changes/corrections
are listed below.

1. Changing a Cause of Death from “Pending”

When the certifier receives the autopsy report, he/she should complete a Supplemental Medical
Certification.

2. Changing Information on a Cause of Death or Other Changes to the Medical Certification

Section
The certifier may make changes or corrections to the medical certification section of the
death certificate by completing a Supplemental Medical Certification.

3. Completing a Supplemental Medical Certification

In most cases when the death certificate was filed through the Electronic Death Registration System
(EDRS), the certifier may be able to complete an electronic Supplemental Medical Certification
through EDRS. If the certifier needs to complete a paper Supplemental Medical Certification,
he/she should contact the Center for Health Statistics at 334.206.2641 to request a Supplemental
Medical Certification Request Form (HS-90) or fax a request to 334.206.2659. When the
Supplemental Medical Certification Request Form has been completed, it should be mailed to:
Center for Health Statistics
Special Services Division
Death Amendment Clerk
P.O. Box 5625
Montgomery, Alabama 36103-5625

4. Changing a Date of Death/Pronouncement and/or Time of Death/Pronouncement

The certifier must submit a signed and dated business letter providing sufficient information to locate
the death certificate and the specific changes which should be made to the death certificate.

Due to the legal issues involved with the amendment of some items, questions regarding amendments to
a death certificate should be referred to 334.206.2641.

ADPH-HS-33/Rev. 05/01/2019
 APPLICATION TO CHANGE AN ALABAMA BIRTH OR DEATH CERTIFICATE
The fee to amend (correct) an Alabama birth or death certificate is $20.00 which includes one certified copy of the amended certificate. The
fee for Paternity Determinations (Legitimations) and/or Adoptions is $25.00 which includes one certified copy of the new certificate. Additional
copies of the same record ordered at the same time are $6.00 each. There is an additional fee of $15.00 to expedite a request. Make check
or money order payable to "Center for Health Statistics." Do not send cash. Fees are non-refundable. Indicate the type of certificate you are
requesting to be corrected. PRINT the information identifying the certificate in the appropriate section. Only one request may be made per
form. You must complete and sign the applicant section or your request cannot be processed. If 19 years of age or older, the record holder
must sign the application when requesting changes to his or her birth certificate.
MAIL THIS COMPLETED FORM WITH VALID IDENTIFICATION AND APPROPRIATE FEE TO:
Center for Health Statistics
P.O. Box 5625, Montgomery, Alabama 36103-5625
Visit our website at: www.alabamapublichealth.gov/vitalrecords.
Birth Certificate Amendments (corrections) may be requested using this form. For further information, call a Birth Amendment Clerk at
334.206.2637.
Refer to the attached Birth Certificate Amendment instructions. In most cases, additional documentation or a court order will be required.
SEE ID REQUIREMENTS ON REVERSE SIDE.

__ BIRTH FULL NAME AS

ON BIRTH CERTIFICATE ________________________________________________________________________________
First Middle Last

DATE OF BIRTH _________________________________________ SEX _________________________________________

Number

of Copies COUNTY OF BIRTH ___________________________ HOSPITAL _______________________________________________

Requested FULL NAME OF MOTHER/PARENT

BEFORE FIRST MARRIAGE _____________________________________________________________________________
_________ FULL NAME OF FATHER/PARENT
BEFORE FIRST MARRIAGE _____________________________________________________________________________

What changes are you requesting? _____________________________________________________________________________________________

____________________________________________________________________________________________________________________________
Death Certificate Amendments (corrections) to the personal/demographic information ONLY may be requested using this form. Questions
regarding changes or corrections to the medical certification section should be referred to the Death Amendment Clerk at 334.206.2641.
Refer to the attached Death Certificate Amendment instructions. In most cases, additional documentation or a court order will be required.
SEE ID REQUIREMENTS ON REVERSE SIDE.

__ DEATH LEGAL NAME OF DECEASED ___________________________________________________________________________

First Middle Last

DATE OF DEATH ___________________________ SSN__________________________________ RACE_______________

Number

of Copies SEX__________ DATE OF BIRTH ___________________________ COUNTY OF DEATH ___________________________

Requested FULL NAME OF MOTHER/PARENT

BEFORE FIRST MARRIAGE _____________________________________________________________________________

_________ FULL NAME OF FATHER/PARENT

BEFORE FIRST MARRIAGE _____________________________________________________________________________
Starting with 1991 deaths, certificates may be issued without a cause of death. Indicate the number of copies of each type of certificate you want:
__________WITH CAUSE OF DEATH _________WITHOUT CAUSE OF DEATH

What changes are you requesting? ______________________________________________________________________________________________

____________________________________________________________________________________________________________________________
APPLICANT SECTION (THIS SECTION MUST BE COMPLETED) Birth certificates less than 125 years old and death certificates less
than 25 years old are restricted records. Valid identification must be submitted with a request to change a birth or death certificate.
Anyone falsely applying for a record is subject to a penalty upon conviction of up to three months in the county jail or a fine of up
to $500. (Code of Alabama 1975, § 13A-10-109). By signing, you are certifying you have a legal right to the record requested.

Your Signature _________________________________________________________________________ Date __________________________________

Print Your Name _________________________________________________________________ Amount Enclosed $ _____________________________

Your Relationship to Person Whose Record is Being Requested _________________________________________________________________________

Mail to Name (if Different from You) _______________________________________________________________________________________________

Mailing Address _______________________________________________________________________________________________________________

City __________________________________________ State ____________ Zip __________________ Daytime Phone ( ) ___________________

I allow the following individual to receive the certificate(s) ______________________________________________________________________________

ADPH-HS-33/Rev. 10/2024
 IDENTIFICATION REQUIREMENTS FOR RESTRICTED ALABAMA VITAL RECORDS

Identification is required of any applicant requesting a restricted Alabama vital record (birth certificate
less than 125 years from the date of birth or death certificate less than 25 years from the date of death). The
applicant must submit a completed request and one form of identification from the Primary ID list below. In
the event the applicant is unable to provide identification from the Primary ID list, he/she may provide two
different forms of identification from the Secondary ID list.
If the applicant designates another individual to pick up a restricted certificate on his/her behalf, both
the applicant and the designee must provide acceptable identification.
The completed request, as well as a copy of all identification submitted, will be maintained by the vital
records office which processes the request.

Primary IDs Including PHOTO Secondary IDs

(need at least one, current, expired no more (need at least two)
than 60 days)
- Alabama Driver’s License
- Out-of-State Driver’s License - Expired, Government-Issued ID
- State-Issued Non-Driver ID - Utility Bill (No more than 6 months old)
- U.S. or Foreign Passport - Work ID (If applicant is making personal
- U.S. Certificate of Naturalization request)
- Certificate of Citizenship - Vehicle Registration or Vehicle Title
- U.S. Military ID - Property Tax Bill
- Work ID (If applicant is employee of - Military Discharge (DD Form 214)
agency/company making request) - Voter Registration Card
- Alien Resident Card (Temporary or - Health Insurance Card
Permanent) - Social Security Correspondence (not
- U.S. Employment Authorization Card Card)
- Citizenship ID Card - U.S. Selective Service Card
- Tribal ID - Recent DMV Receipt for Fines Paid
- Pilot’s License - Fishing or Hunting License
- Boating License - Copy of Police Report or other official
- Concealed Weapons License documents which support theft, in cases
- Ex-Felon ID where individual’s ID has been stolen
- Inmate ID issued by the U.S. Dept of - Autism Spectrum Card
Justice w/ following documentation: - Immunization (Shot) Record
o Supporting documents from
institution if inmate is still in *In special cases where applicant is unable to
custody, letter of release from provide any of these documents, please contact
institution if inmate has been CHS at 334.206.5418.
released
- School ID (Must include current school
term)
- Alabama Voter Identification Card
 APPLICATION TO ADD FATHER TO CHILD’S ALABAMA BIRTH CERTIFICATE
Please complete this form to add the father’s information to the birth certificate of the child listed below. Before we begin to process your
request, additional information, valid identification (see reverse side) and/or documents are needed. Please answer the following questions
and provide the documents as indicated when you return this form. After reviewing the information you provide, we will advise you if other
documents will be required or if a court action is needed. If you are not a parent of the child or if you do not have legal custody of the child, we
may not be able to process your request.
The fee to prepare the new birth certificate is $25.00 which includes one certified copy of the new birth certificate. Additional copies of the same
record ordered at the same time are $6.00 each. There is an additional fee of $15.00 to expedite a request. Make check or money order
payable to “Center for Health Statistics.” Do not send cash. Fees are not refundable if the action cannot be completed due to non-receipt of
the required documents. However, we will return the fee if we determine you are not legally authorized to make the request.
INFORMATION ON APPLICANT (THIS SECTION MUST BE COMPLETED) Valid identification must be submitted with a request to change a
birth certificate. Anyone falsely applying for a record is subject to a penalty upon conviction of up to three months in the county jail or a fine of up
to $500. (Code of Alabama 1975, § 13A-10-109). By signing, you are certifying you have a legal right to the record requested.

Your Signature _______________________________________________________ Date ______________________________________

Print Your Name _________________________________________ Number of Copies ___________ Amount Enclosed $ _____________

Your Relationship to Child _________________________________________________________________________________________

Mail to Name (if Different from You) _________________________________________________________________________________

Mailing Address _________________________________________________________________________________________________

City _______________________________ State ________ Zip ________________ Daytime Phone (_____ ) ______________________

I allow the following individual to receive the certificate(s) ________________________________________________________________

INFORMATION TO LOCATE CHILD’S BIRTH CERTIFICATE
CHILD’S FULL NAME AS SHOWN ON BIRTH CERTIFICATE ____________________________________________________________
First Middle Last

CHILD’S DATE OF BIRTH _____________________________ CHILD’S COUNTY OF BIRTH ________________________________________

MOTHER’S FULL NAME BEFORE FIRST MARRIAGE ___________________________________________________________________________

MOTHER’S LEGAL NAME AT TIME OF BIRTH __________________________________________________________________________________

INFORMATION REGARDING CHILD’S PARENTAGE

1. Do you want the father’s name added to the child’s birth certificate? _______Yes _______No
2. Do you want to change the child’s name on the birth certificate when you add the
father’s name? _______Yes _______No
3. Was the mother married to anyone at the time of the child’s birth, or within 300 days
before the child’s birth? _______Yes _______No
4. Have the father and mother married since the child was born?
If Yes, send a certified copy of the marriage certificate. _______Yes _______No
5. Has an individual ever claimed to be the father of this child in court?
If Yes, send a certified copy of the court order. _______Yes _______No
6. Has the child support court or any other type of court ever declared an individual to
be the father of this child? If Yes, send a certified copy of the court order. _______Yes _______No
7. Has a court established legal custody for this child?
If Yes, send a certified copy of the custody order. _______Yes _______No
8. What is the father’s name, date of birth and state of birth?

Father’s Name _________________________________________Father’s Date of Birth ________________ Father’s State of Birth _______

MAIL THIS COMPLETED FORM WITH VALID IDENTIFICATION AND APPROPRIATE FEE TO:
Center for Health Statistics
Attn: Legitimations
P. O. Box 5625
Montgomery, Alabama 36103-5625
If you have any questions, call 334.206.2637. Visit our website at: www.alabamapublichealth.gov/vitalrecords.
ADPH-HS-75/Rev. 10/2024
 IDENTIFICATION REQUIREMENTS FOR RESTRICTED ALABAMA VITAL RECORDS

Identification is required of any applicant requesting a restricted Alabama vital record (birth certificate
less than 125 years from the date of birth or death certificate less than 25 years from the date of death). The
applicant must submit a completed request and one form of identification from the Primary ID list below. In
the event the applicant is unable to provide identification from the Primary ID list, he/she may provide two
different forms of identification from the Secondary ID list.
If the applicant designates another individual to pick up a restricted certificate on his/her behalf, both
the applicant and the designee must provide acceptable identification.
The completed request, as well as a copy of all identification submitted, will be maintained by the vital
records office which processes the request.

Primary IDs Including PHOTO Secondary IDs

(need at least one, current, expired no more (need at least two)
than 60 days)
- Alabama Driver’s License
- Out-of-State Driver’s License - Expired, Government-Issued ID
- State-Issued Non-Driver ID - Utility Bill (No more than 6 months old)
- U.S. or Foreign Passport - Work ID (If applicant is making personal
- U.S. Certificate of Naturalization request)
- Certificate of Citizenship - Vehicle Registration or Vehicle Title
- U.S. Military ID - Property Tax Bill
- Work ID (If applicant is employee of - Military Discharge (DD Form 214)
agency/company making request) - Voter Registration Card
- Alien Resident Card (Temporary or - Health Insurance Card
Permanent) - Social Security Correspondence (not
- U.S. Employment Authorization Card Card)
- Citizenship ID Card - U.S. Selective Service Card
- Tribal ID - Recent DMV Receipt for Fines Paid
- Pilot’s License - Fishing or Hunting License
- Boating License - Copy of Police Report or other official
- Concealed Weapons License documents which support theft, in cases
- Ex-Felon ID where individual’s ID has been stolen
- Inmate ID issued by the U.S. Dept of - Autism Spectrum Card
Justice w/ following documentation: - Immunization (Shot) Record
o Supporting documents from
institution if inmate is still in *In special cases where applicant is unable to
custody, letter of release from provide any of these documents, please contact
institution if inmate has been CHS at 334.206.5418.
released
- School ID (Must include current school
term)
- Alabama Voter Identification Card
 APPLICATION TO REQUEST A NEW BIRTH CERTIFICATE AFTER ADOPTION
When a child is adopted through an Alabama court, the court forwards the order of adoption and information showing the child’s new name
and the names of the new parents to the Center for Health Statistics in Alabama. Upon receipt of the information, the Center for Health
Statistics will do one of the following depending upon where the child was born:

IF THE ADOPTED CHILD WAS BORN IN ALABAMA:

• The Center for Health Statistics will prepare a new birth certificate for the child showing the new names.
• The fee to prepare the new certificate of birth after adoption is $25.00 which includes one certified copy of the new record. Additional
copies of the same record ordered at the same time are $6.00 each. There is an additional fee of $15.00 to expedite a request.
• To obtain a copy of the child’s new birth certificate, complete the application form below. Valid identification must be submitted
with a request for a new Alabama birth certificate after adoption. See the identification requirements on the reverse side.

IF THE ADOPTED CHILD WAS BORN IN ANOTHER STATE:

• The new birth certificate for the child must be prepared in the state where the child was born.
• The fee for the Center for Health Statistics to forward the order of adoption to the child’s state of birth is $10.00.
• Upon receipt of the fee, the Center for Health Statistics will forward the court order of adoption and the information showing the new
name to the appropriate vital records office in the state where the child was born.
• You will need to contact the state of birth for a copy of the new certificate.

Make check or money order payable to “Center for Health Statistics.” Do not send cash. Fees are non-refundable. Complete the
application below and send with the required documents and appropriate fee to:
Center for Health Statistics
Attn: Adoptions
P.O. Box 5625
Montgomery, Alabama 36103-5625

Please allow 2-4 weeks after the court action has been completed before mailing your request, valid identification (if requesting an Alabama
birth certificate) and fee. If this is an adult adoption or you have additional questions, call 334.206.2637. Visit our website at
www.alabamapublichealth.gov/vitalrecords.

IF THE CHILD WAS BORN IN A FOREIGN COUNTRY, DO NOT COMPLETE THIS FORM. Call 334.206.2637 for additional information
and appropriate forms.

FULL NAME OF CHILD BEFORE ADOPTION (IF KNOWN) ____________________________________________________________________________

First Middle Last

FULL NAME OF CHILD AFTER ADOPTION ________________________________________________________________________________________

First Middle Last

STATE OF BIRTH ______________________________________COUNTY OF BIRTH ______________________________________________________

DATE OF BIRTH _________________________________________________ SEX ________________________________________________________

FULL NAME OF ADOPTIVE MOTHER/PARENT

BEFORE FIRST MARRIAGE _____________________________________________________________________________________________________

FULL NAME OF ADOPTIVE FATHER/PARENT

BEFORE FIRST MARRIAGE _____________________________________________________________________________________________________

APPLICANT SECTION If Alabama Birth, Amount

(THIS SECTION MUST BE COMPLETED) Number of Copies ______________ Enclosed $ ________________
Valid identification must be submitted with a request to change a birth certificate. Anyone falsely applying for a record is subject to
a penalty upon conviction of up to three months in the county jail or a fine of up to $500. (Code of Alabama 1975,
§ 13A-10-109). By signing, you are certifying you have a legal right to the record requested.

Your Signature ______________________________________________________________________ Date _____________________________________

Print Your Name ______________________________________________________________________________________________________________

Your Relationship to Child _______________________________________________________________________________________________________

Mail to Name (if Different from You) _______________________________________________________________________________________________

Mailing Address __________________________________________________________________________________________________

City _________________________________ State _____________ Zip _________________ Daytime Phone (_________) _________________________

I allow the following individual to receive the certificate(s) ______________________________________________________________________________

ADPH-HS-88/Rev. 10/2024
 IDENTIFICATION REQUIREMENTS FOR RESTRICTED ALABAMA VITAL RECORDS

Identification is required of any applicant requesting a restricted Alabama vital record (birth certificate
less than 125 years from the date of birth or death certificate less than 25 years from the date of death). The
applicant must submit a completed request and one form of identification from the Primary ID list below. In
the event the applicant is unable to provide identification from the Primary ID list, he/she may provide two
different forms of identification from the Secondary ID list.
If the applicant designates another individual to pick up a restricted certificate on his/her behalf, both
the applicant and the designee must provide acceptable identification.
The completed request, as well as a copy of all identification submitted, will be maintained by the vital
records office which processes the request.

Primary IDs Including PHOTO Secondary IDs

(need at least one, current, expired no more (need at least two)
than 60 days)
- Alabama Driver’s License
- Out-of-State Driver’s License - Expired, Government-Issued ID
- State-Issued Non-Driver ID - Utility Bill (No more than 6 months old)
- U.S. or Foreign Passport - Work ID (If applicant is making personal
- U.S. Certificate of Naturalization request)
- Certificate of Citizenship - Vehicle Registration or Vehicle Title
- U.S. Military ID - Property Tax Bill
- Work ID (If applicant is employee of - Military Discharge (DD Form 214)
agency/company making request) - Voter Registration Card
- Alien Resident Card (Temporary or - Health Insurance Card
Permanent) - Social Security Correspondence (not
- U.S. Employment Authorization Card Card)
- Citizenship ID Card - U.S. Selective Service Card
- Tribal ID - Recent DMV Receipt for Fines Paid
- Pilot’s License - Fishing or Hunting License
- Boating License - Copy of Police Report or other official
- Concealed Weapons License documents which support theft, in cases
- Ex-Felon ID where individual’s ID has been stolen
- Inmate ID issued by the U.S. Dept of - Autism Spectrum Card
Justice w/ following documentation: - Immunization (Shot) Record
o Supporting documents from
institution if inmate is still in *In special cases where applicant is unable to
custody, letter of release from provide any of these documents, please contact
institution if inmate has been CHS at 334.206.5418.
released
- School ID (Must include current school
term)
- Alabama Voter Identification Card