Name of the Organization : Arizona Department of Health
Type of Facility : Change a Parent’s Name on a Birth Certificate
State : Arizona
Country : United States of America
Website : http://www.azdhs.gov/licensing/vital-records/index.php#corrections-amendments-parents-name
Correction Form : https://www.statusin.org/uploads/24293-correctionbirth.pdf
Change a Parent’s Name on a Birth Certificate :
Mother’s Name Prior to First Marriage :
** The mother’s name prior to first marriage is listed on the registrant’s birth certificate.
** This is often the name listed on the mother’s birth certificate (birth name).
Related : Arizona Department of Health Change a Childs Name on a Birth Certificate : www.statusin.org/24289.html
To amend the mother’s name prior to first marriage, the following must be submitted:
** A completed Application for Certified Copy of Birth Certificate
** A copy of the front and back of your valid government-issued picture identification which bears your signature or have your signature notarized.
Note :
** If you are the legal guardian of the registrant, you must also submit proof of eligibility.
** Include a self-addressed stamped envelope with your request.
** The amendment fee, according to the fee schedule.
** Acceptable payment methods are: cashier’s checks, money orders, Visa, or MasterCard.
** Please Do Not Send Cash.
** Cashier’s checks and money orders must be for the exact amount and made payable to Office of Vital Records.
** If you pay by credit/debit card, you must include the full card number and expiration date on your application.
** A certified copy of the mother’s birth certificate.
** The completed Affidavit to Correct or Amend a Birth Certificate form.
** This form must be signed in the presence of a notary.
Parent Changed Legal Name :
** Parents may change their name on the registrant’s birth certificate if the parent has legally changed their name in a superior court or other court of competent jurisdiction.
The following is required to amend the registrant’s birth certificate :
** A completed Application for Certified Copy of Birth Certificate
** A copy of the front and back of your valid government-issued picture identification which bears your signature or have your signature notarized.
Note :
** If you are the legal guardian of the registrant, you must also submit proof of eligibility.
** Include a self-addressed stamped envelope with your request.
** The amendment fee, according to the fee schedule.
Acceptable payment methods are :
** cashier’s checks, money orders, Visa, or MasterCard.
** Please Do Not Send Cash.
** Cashier’s checks and money orders must be for the exact amount and made payable to Office of Vital Records.
** If you pay by credit/debit card, you must include the full card number and expiration date on your application.
** A certified copy of the parents’ birth certificate that shows the legal name or a certified copy of the court order listing their previous name (name listed on registrant’s birth certificate) and the new legal name.
Note :
** To delay processing the request and to provide a link between the two names, both documents may be submitted.
** The completed Affidavit to Correct or Amend a Birth Certificate form.
** This form may be required if the court order referenced in #5 above does not clearly specify the name(s) that should be listed in the first, middle, last and suffix fields on the birth certificate for the parent.
** This form must be signed in the presence of a notary.
The following is required to amend the registrant’s birth certificate :
** A completed Application for Certified Copy of Birth Certificate [Español]
** A copy of the front and back of your valid government-issued picture identification which bears your signature or have your signature notarized.
Note :
** If you are the legal guardian of the registrant, you must also submit proof of eligibility.
** Include a self-addressed stamped envelope with your request.
** The amendment fee, according to the fee schedule.
** Acceptable payment methods are: cashier’s checks, money orders, Visa, or MasterCard.
** Please Do Not Send Cash.
** Cashier’s checks and money orders must be for the exact amount and made payable to Office of Vital Records.
** If you pay by credit/debit card, you must include the full card number and expiration date on your application.
** A certified copy of the court order.
** The completed Affidavit to Correct or Amend a Birth Certificate form.
** This form may be required if the court order referenced in #5 above does not clearly specify the name(s) that should be listed in the first, middle, last and suffix fields on the birth certificate for the parent.
** This form must be signed in the presence of a notary.