North Carolina Birth Certificate Modification Application (DHHS 1578)

Who can use this form

• If the person on the certificate is under 18: the parent or parents listed on the certificate, or the legal guardian with the original guardianship order.
• For a name or sex designation change for a minor: both parents listed on the certificate, or the legal guardian, must sign.
• If the person on the certificate is 18 or older: that person, or an agent with an original notarized power of attorney.
• Applicants who cannot supply the required evidence or proof of identity must get a court order.

What to send with it

• Page 1 completed and signed in front of a notary public. Each extra copy of page 1 must also be notarized.
• A legible photocopy of one primary photo ID, or two alternate IDs, from the list on page 2. The address on the application must match the ID.
• The documentary evidence listed on pages 4 to 8 for the field being changed, as originals or certified copies. For example, a certified court order for a legal name change.
• A certified check or money order for $39 payable to N.C. Vital Records. Personal checks and cash are not accepted.

Where to send it

Mail to

See the form for where to file it.

State fee

$39 (amendment, correction, paternity or legitimation), printed on the form. Not refunded if the application is denied. The office's Change a Record page says this is a $24 search fee plus a $15 processing fee and includes one copy of the amended certificate.

Typical processing

The office's Change a Record page says birth amendment requests are to be processed within 30 calendar days after the completed, notarized application, required evidence and verified payment are received. Court order, legitimation, paternity and adoption requests are processed in the order received.

Form revision

07/2022

Source

Official government page