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New York Notarized Affidavit of Gender Change for a Person 17 Years of Age or Older (DOH-5303)

Official state formSex designation changeForm DOH-5303Free downloadLast verified November 10, 2026

Notarized affidavit a person 17 or older signs to support an application to amend the gender designation on their birth certificate. It is enclosed with the adult application (DOH-5305) sent to the New York State Department of Health.

Who can use this form

  • A person who is currently 17 years of age or older and is seeking to amend the gender designation on their own birth certificate.
  • The person states that they have been living in their correct gender immediately before the application.
  • The person signs in front of a notary public.

What to send with it

  • The completed affidavit, signed and notarized.
  • The Application for Amendment of Certificate of Birth for Gender Designation for an Adult (DOH-5305), which this affidavit goes with.

Where to send it

Mail to
See the form for where to file it.
State fee
Not provided
Typical processing
Not provided
Form revision
1/23
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New York Notarized Affidavit of Gender Change for a Person 17 Years of Age or Older (DOH-5303) | New York Form