Pennsylvania Department of Health - Vital Records · Pennsylvania state form
HD002291 Request to Modify a Teenage Child’s Birth Record
Spanish-language application for a parent or eligible custodian to request changes to a teenager’s birth record, with supporting documents and signatures as required.
- What this form is
- Use form HD002291 to request a modification to a birth record for a teenager aged 14 to under 18. The application asks for contact and identification information, the reason for the request, and the changes sought. Depending on the change, supporting documents may be required. Parents listed on the record generally must sign Part 6 before a notary, subject to the exceptions described in the form.
- Who needs it
- A parent or eligible custodian requesting a change to the birth record of a teenager aged 14 to under 18.
- Why it needs a notary
- The required signatures in Part 6 must be notarized. This can be done online with a commissioned online notary.
- How to submit it
- Mail the completed application, required identification, applicable supporting documents, and payment or fee-waiver materials to the Birth Registry address printed on the form.
Questions
Who can use form HD002291?
A parent or eligible custodian can use this application to request changes to a birth record for a teenager aged 14 to under 18.
Does form HD002291 need to be notarized?
Yes. The form says the required signatures in Part 6 must be signed in the presence of a notary. Online notarization is available with a commissioned online notary.
What documents should be sent with the application?
Include a legible copy of acceptable identification and any supporting documents required for the requested change. The form lists examples and explains that requirements depend on the type of modification.