Arkansas Birth Parent Redaction Request Form (Form C) (VR-503)
Official state formAdoptionForm VR-503Free downloadLast verified November 10, 2026
A birth parent of an adopted person uses this form to direct the State Registrar to redact his or her name from the copy of the adoption file released to a qualified requester. It is filed with Arkansas Department of Health Vital Records in Little Rock.
Who can use this form
- A birth parent of an adopted person completes the form.
- A birth parent may redact only his or her own name, not the other parent's.
- The office holds adoption files only for persons born in Arkansas.
What to send with it
- The signed and notarized form.
- A Family History Information Form (Form B), if the history was not compiled before.
- A copy of the birth parent's identification, as listed in the Birth Parent Information Instructions. Send copies, not originals.
Where to send it
- Mail to
- Arkansas Department of Health Vital Records Department State Registrar 4815 West Markham Street, Slot 44 Little Rock, AR 72205
- State fee
- Not provided
- Typical processing
- Not provided
- Form revision
- May 2018
- Source
- Official government page