Utah Affidavit to Amend a Death 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 death record without a court order. 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
- The informant and an immediate family member, or two immediate family members, sign as witnesses
- If a spouse is being added, the spouse must sign as a witness
- If no immediate family is available, a person who knows the facts may sign
- Not used with a court order and not for 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