Florida Affidavit of Amendment to a Certificate of Death (DH 433)
Official state formCorrections and amendmentsForm DH 433Free downloadLast verified November 10, 2026
Notarized affidavit for non-medical corrections to a Florida death certificate. It lists the item in error, what the record shows and what it should say. It is sent with application DH 524 to the Bureau of Vital Statistics Correction Unit.
Who can use this form
- The informant or next of kin must sign before a notary.
- The funeral director who filed the original death certificate must also sign before a notary.
- The surviving spouse item can be changed only by court order, except for a misspelling or an omission.
What to send with it
- Notarized affidavit with no erasures or alterations
- Application DH 524 with the fee
- Documentary evidence for: the name of the deceased (other than a misspelling), a date of birth changed by more than 3 months, citizenship changed from alien to U.S. citizen, and names of parents
- Evidence must be original, certified or notarized documents. The office returns them.
Where to send it
- Mail to
- FLORIDA DEPARTMENT OF HEALTH BUREAU OF VITAL STATISTICS ATTN: CORRECTION UNIT P.O. BOX 210 JACKSONVILLE, FL 32231-0042
- State fee
- $20 amendment processing fee, non-refundable, includes one certification of the amended record. The fee is stated on the office's amendments page and on application DH 524, not on the affidavit.
- Typical processing
- Not provided
- Form revision
- 01/2022
- Source
- Official government page