Missouri DHSS - Vital Records Applications and Forms · Missouri state form
Affidavit for Correction of a Birth, Death, or Fetal Death Record MO 580-0645
Use this affidavit to request corrections to a birth, death, or fetal death record. Submit the completed original with documentary evidence supporting the requested corrections.
- What this form is
- This affidavit is for an individual legally authorized to request a correction to a birth, death, or fetal death record. Identify the record and the items to be corrected, provide affiant information, and include documentary evidence supporting the request. The original must be complete and free of erasures, write-overs, and white-out. The affidavit must be signed in the presence of a notary public.
- Who needs it
- An individual legally authorized to correct a birth, death, or fetal death record who is requesting a correction to that record.
- Why it needs a notary
- The affidavit must be signed in the presence of a notary public. You can complete the notarization online with a commissioned online notary.
- How to submit it
- Mail the original completed affidavit and supporting documentary evidence to DHSS - Bureau of Vital Records, 930 Wildwood Dr., Jefferson City, MO 65109.
Questions
What records can this affidavit be used to correct?
The form is titled Affidavit for Correction of a Birth, Death, or Fetal Death Record. It asks you to identify the record and the items to be corrected.
Does this affidavit need to be notarized?
Yes. The document says the affidavit must be signed in the presence of a notary public. Online notarization with a commissioned online notary is an option.
What must I submit with the affidavit?
Submit the original, fully completed affidavit, free of erasures, write-overs, and white-out, along with documentary evidence supporting the requested correction.