Wisconsin Report of Court Order to Amend a Birth Record (F-05091)
Official state formCorrections and amendmentsForm F-05091Free downloadLast verified November 14, 2026
Used after a circuit court orders a correction to facts wrongly recorded on a Wisconsin birth record. The clerk of court completes and seals Part III, then the form goes to the Wisconsin State Vital Records Office with the fee.
Who can use this form
- A person whose birth record does not show the actual facts, after the circuit court in the county of birth grants the petition.
- Part III must be completed and sealed by the clerk of court before the form is returned to the office.
- Not for a legal name change or for adding or removing a parent.
What to send with it
- The completed form, signed and sealed by the clerk of court.
- A check or money order payable to State of Wis. Vital Records.
- A current certified copy of the birth record, which the form says to gather with the evidence for the court.
- Fees listed on the form: $10 to file and $20 for the first certified copy, with $3 for each additional copy.
Where to send it
- Mail to
- State Vital Records Office ATTN: PSSU PO Box 309 Madison, WI 53701-0309
- State fee
- $10 filing fee; certified copies $20 for the first (long or short form) and $3 for each additional. All as printed on the form.
- Typical processing
- Not provided
- Form revision
- 08/2026
- Source
- Official government page