Pennsylvania Department of Health - Vital Records · Pennsylvania state form
HD002272 Infant Birth Record Modification Application (Spanish)
Spanish application to request changes to a Pennsylvania birth record for a baby under one year old, with identification, supporting-document, and signature requirements.
- What this form is
- Use Form HD002272 to request a modification to a birth record for a baby under one year old. The form collects applicant and baby information, the requested changes, identification details, and any applicable supporting documents. It cannot be used for adoption-related changes or changes to parentage. All parents listed on the record generally must sign, subject to the exceptions described in the form.
- Who needs it
- A parent or other eligible person seeking to modify a Pennsylvania birth record for a baby under one year old may use this application.
- Why it needs a notary
- Notarization is required when the baby’s or a parent’s last name is changing without a court order; this can be done online with a commissioned online notary.
- How to submit it
- Mail the completed application and applicable documents to Pennsylvania Department of Health, Bureau of Health Statistics and Registries, ATTN: Birth Registry, 555 Walnut St., 6th Floor, Harrisburg, PA 17101-1934.
Questions
Who can use Form HD002272?
The form is for requesting changes to a birth record for a baby under one year old. It cannot be used for adoption-related changes or changes to parentage.
Does this application need to be notarized?
Notarization is required if the baby’s or a parent’s last name is changing and no court order authorizes the change. The form says to sign in the presence of a notary; online notarization is available with a commissioned online notary.
Where should I mail the completed application?
Mail it to the Pennsylvania Department of Health, Bureau of Health Statistics and Registries, ATTN: Birth Registry, 555 Walnut St., 6th Floor, Harrisburg, PA 17101-1934. Include applicable supporting documents.