Florida Application for Amendment to a Death or Fetal Death Certificate (DH 524)
Official state formCorrections and amendmentsForm DH 524Free downloadLast verified November 10, 2026
Cover application and fee sheet for a medical or non-medical amendment to a Florida death or fetal death record, and to order certificates of the amended record. It is sent with the matching affidavit to the Bureau of Vital Statistics Corrections Unit.
Who can use this form
- Any person 18 or older, for a record without cause of death
- With cause of death: spouse, parent, child, grandchild or sibling (18 or older), a person with a documented interest in the estate, their representative, or a person with a court order
- An attorney or funeral director, with license number and client details
What to send with it
- Completed application
- Copy of valid photo ID, when requesting cause of death
- Non-medical changes: affidavit DH 433 (death) or DH 433A (fetal death)
- Medical changes: form DH 434A from the physician or medical examiner
- Documentary evidence, where required
- Check or money order payable to Vital Statistics
Where to send it
- Mail to
- DEPARTMENT OF HEALTH BUREAU OF VITAL STATISTICS ATTN: CORRECTIONS UNIT P.O. BOX 210 JACKSONVILLE, FL 32231-0042
- State fee
- Non-medical amendment: $20.00 (includes the first certificate). Medical amendment: no amendment fee, $5.00 for the first certificate. $4.00 for each additional certificate; optional $10 rush fee; $1.00 shipping and handling.
- Typical processing
- Generally two to three weeks. Rush orders get priority.
- Form revision
- 03/2020
- Source
- Official government page