Florida Affidavit of Amendment of Certificate of Live Birth (DH 430)
Official state formCorrections and amendmentsForm DH 430Free downloadLast verified November 10, 2026
Notarized affidavit that lists each item missing or wrong on a Florida birth certificate, what the record shows and what it should say. It is sent with application DH 429 to the Bureau of Vital Statistics Correction Unit.
Who can use this form
- The person named on the record must sign if 18 or older.
- If that person is under 18: a parent listed on the certificate or the legal guardian signs.
- If the registrant's name is changed: the parents as listed, or the legal guardians, sign.
- To change the name of a child under 18, both listed parents must sign; otherwise a court order is needed.
What to send with it
- Notarized affidavit with no erasures or alterations
- Application DH 429
- Check or money order for the fee
- Documentary evidence for the items that the DH 660 instructions list
- Evidence must be original, certified or notarized documents. The office returns them after review.
Where to send it
- Mail to
- 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 429, not on the affidavit.
- Typical processing
- Not provided
- Form revision
- 01/2022
- Source
- Official government page