New York State Department of Health - Vital Records (birth) · New York state form
DOH-1862 Affidavit for Conforming Name Change
DOH-1862 is an affidavit for parents to consent to a conforming change of their child’s name on an amended birth certificate after a parentage determination.
- What this form is
- The New York State Department of Health Vital Records form asks the father and mother to provide information about themselves, the child, and the parentage determination. Both parents must agree on the child's name and complete the forms. The affidavit records their consent to the child's name on the amended birth certificate. If the parents do not agree, the name remains as shown on the original birth certificate unless changed by court order.
- Who needs it
- Both parents complete the affidavit when they agree on the child's name for an amended birth certificate after a parentage determination.
- Why it needs a notary
- Both parents' signatures must be notarized. This can be done online with a commissioned online notary.
- How to submit it
- Both parents must complete the forms, sign them, and have their signatures notarized. The document lists the Vital Records Amendment Unit at P.O. Box 2602, Albany, NY 12220-2602.
Questions
Who completes DOH-1862?
Both the father and mother complete the affidavit when they agree on the child's name to be recorded on the amended birth certificate.
Does DOH-1862 need to be notarized?
Yes. The document says both parents must sign and notarize the forms. This can be done online with a commissioned online notary.
What happens if the parents do not agree on the child's name?
The document states that the child's name on the amended birth certificate will remain as it appears on the original birth certificate. A court order is required to change the child's name.