Arizona Adoption Worksheet
Official state formAdoptionFree downloadLast verified November 10, 2026
Collects the adoptive parent information required by A.A.C. R9-19-208(M) that is not in the adoption order, so the Bureau of Vital Records can amend the Arizona birth certificate after an adoption. It is sent to the Bureau in Phoenix.
Who can use this form
- The adoptive parents complete the worksheet and must sign it.
- It collects only the required information that is missing from the adoption order. No other additions or changes can be made with it.
What to send with it
- The completed worksheet.
- The Request for Copy of Birth Certificate (VS-11).
- A copy of the front and back of an ID or a notarized signature, plus proof of eligibility if the applicant is not the registrant or a parent.
- A certified final decree of adoption from the superior court.
- A self-addressed stamped envelope and the fee.
- This list and the mailing address come from the office's adoption web page. The worksheet itself prints no address.
Where to send it
- Mail to
- Bureau of Vital Records Attn: Adoptions P.O. Box 6018 Phoenix, AZ 85005
- State fee
- $30.00 according to the office's adoption web page; additional copies are $20.00 each. The worksheet itself prints no fee.
- Typical processing
- Not provided
- Form revision
- Rev. 4-14-25
- Source
- Official government page