Florida DH Form 430, the Affidavit of Amendment of Certificate of Live Birth, is the sworn statement you file with the Florida Bureau of Vital Statistics to correct or change information on a Florida birth certificate. You fill out only the top half of the form, sign it in front of a notary, and mail it with DH Form 429, any required supporting documents, a copy of your photo ID, and a $20 fee to the Bureau in Jacksonville.1Florida Statute 382.016
When to Use DH Form 430
The affidavit covers more than legal name changes. Common reasons for filing include correcting a misspelled name, updating a child’s surname after a paternity acknowledgment, adding or changing a given name before the child’s first birthday, and amending the record to match a court-ordered name change.
Whether you need supporting documents depends on the type of change. Under Florida Administrative Code Rule 64V-1.003, some amendments — such as adding a given name or changing a child’s name before the first birthday — require only the affidavit. Correcting the registrant’s name after the first birthday, or making most other substantive changes, requires original, certified, or notarized supporting evidence such as a court order or marriage certificate. A plain photocopy will not be accepted.
How to Fill Out Each Field
Use black ink. Type or print clearly. The affidavit becomes a permanent part of the birth record, and the Bureau will reject a form with erasures or alterations.
You only complete the upper half. The lower half is reserved for the Bureau of Vital Statistics after it reviews the request.
- Registrant’s Full Name at Birth. Enter the name as it should appear on the birth certificate after the amendment, not the name currently on the record. The field label says “at birth,” but the instructions direct you to enter the corrected version. This one trips people up.
- State File Number. Enter it if you know it. Leave it blank if you don’t.
- Birth Date and Birth Place. Enter the correct date and place of birth.
- Column 1 — Item Omitted or in Error. Name the item that needs to change. Examples: “Child’s Full Name,” “Mother’s/Parent’s Name prior to first marriage,” “Father’s/Parent’s Name,” “Date of Birth.”
- Column 2 — Birth Certificate Shows. Write exactly what currently appears on the certificate for that item.
- Column 3 — Should Be. Write the correct information that should replace it.
The three-column grid is the heart of the form. Each row is one correction. If you need to fix a name and a date of birth, those are two separate rows.
Who Signs, and in Front of a Notary
DH Form 430 is an affidavit, so it must be signed under oath in front of a notary public. Mailing an un-notarized form is one of the fastest ways to get a rejection. Florida Administrative Code Rule 64V-1.002 sets out who signs:2Florida Administrative Code Rule 64V-1.002
- If the registrant is 18 or older, the registrant signs.
- If the registrant is under 18, a parent named on the certificate, a legal guardian, or an agency with legal custody signs on the minor’s behalf.
- If the amendment changes the name of a registrant under 18 and both parents are named on the original record, both the mother/parent and the father/parent must sign, and both signatures must be notarized.
A minor whose disability of nonage has been removed by a court may sign for themselves if they submit proof of the removal. Notary services are available at banks, UPS stores, courthouses, and many law offices.
What to Send With the Form
A complete amendment package has four parts. Missing any one of them delays or rejects the request.
- DH Form 429, Application for Amendment to Florida Birth Record. The cover application. It identifies who is requesting the change and provides mailing and contact information.
- DH Form 430, notarized. The affidavit describing exactly what needs to change.
- Supporting documentary evidence if your type of change requires it. Depending on the correction, this may be a certified copy of a court order, marriage certificate, divorce decree, or paternity acknowledgment. Original, certified, or notarized only.
- A photocopy of valid photo ID for the person submitting the request: driver’s license, state ID card, passport, or military ID.
Both forms, along with the instruction sheet DH Form 660, are available on the Florida Department of Health website under the amendments and corrections section.
Fee and Payment
The processing fee is $20, which includes one certified copy of the amended birth certificate. Florida Statute 382.0255 authorizes a charge between $10 and $20 for a birth record amendment; the Bureau charges the statutory maximum.3Florida Statute 382.0255 Additional certified copies ordered at the same time cost between $2 and $4 each.
Make the check or money order payable to “Vital Statistics.” Not “Florida Department of Health,” not any other variation. Do not send cash. International payments must be a cashier’s check or money order in U.S. dollars drawn on a U.S. bank. The fee is non-refundable whether the amendment is approved or denied.
Where to Mail It
Send the package to:
Bureau of Vital Statistics
P.O. Box 210
Jacksonville, FL 32231-0042
Keep a record of your mailing date and payment method so you can follow up if the amended certificate doesn’t arrive.
After the Bureau Receives It
Staff review the affidavit and supporting documents against the existing birth record. If everything is in order, they update the record and mail a new certified birth certificate to the address on DH Form 429. If the package is incomplete — un-notarized affidavit, missing court order, illegible entries — the Bureau will return or hold the request until you provide what’s missing, adding weeks to the timeline. Getting it right the first time is the fastest route.
Other Records Don’t Update Automatically
An amended Florida birth certificate updates the state vital record only. Your Social Security card, U.S. passport, and Florida driver’s license each draw from separate systems and have their own name-change procedures. If the amendment changes your legal name, plan to update those records separately using the amended certificate and any court order as supporting proof. Handling the driver’s license before your current one expires avoids REAL ID complications at renewal.