Utah Affidavit to Amend a Birth Record (DHHS-OVRS-901)
Official state formCorrections and amendmentsForm DHHS-OVRS-901Free downloadLast verified November 10, 2026
Notarized affidavit signed by two witnesses to correct a Utah birth record without a court order. The same form also covers stillbirth records. An item can be corrected by affidavit only once. It is mailed to the Utah Office of Vital Records and Statistics.
Who can use this form
- If the person on the record is under 18: both parents of record sign as witnesses
- If only one parent is listed: that parent and an immediate family member of that parent
- If the person on the record is 18 or older: that person and an immediate family member
- Not used with a court order
- Not for gender or name changes after age one, delayed birth certificates or medical information
What to send with it
- The completed affidavit, with both witness signatures notarized
- Supporting proofs that match the stated facts exactly
- Any copies of the certificate being corrected
- The correct fees, proof of ID and an application for a new certificate
Where to send it
- Mail to
- Office of Vital Records and Statistics PO Box 141012 Salt Lake City, UT 84114-1012
- State fee
- The form does not print an amount. The office's fee page lists a $25.00 amendment fee, in addition to the certificate fee. The form says the new certificate fee is waived if the corrected certificate is reissued within 90 days, but affidavit fees may still apply.
- Typical processing
- About 6 to 12 weeks, according to the office's amendment page.
- Form revision
- Rev. 2026
- Source
- Official government page