To Correct Typographical Errors on Records of Birth One Year or Older APPLICANT: COMPLETE PARTS 1 AND 2 ONLY. TYPE OR PRINT LEGIBLY. SEE INSTRUCTIONS ON REVERSE SIDE. PART 1. THIS INFORMATION MUST BE THE SAME AS ON THE BIRTH CERTIFICATE PERSON NAMED ON RECORD SEX First Middle DATE OF BIRTH Month Day Year PLACE OF BIRTH MOTHER’S NAME First Middle FATHER’S NAME Middle PART 2. First City County Maiden Last Name Current Last Name Last (surname) Suffix (Jr., Sr., II, III, IV) .
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How to fill out the IA CPA-4924 online
Filling out the IA CPA-4924 form is an essential step for correcting typographical errors on records of birth that are one year or older. This guide will walk you through the process of completing the form online, providing clear and concise instructions for each section.
Follow the steps to successfully complete the IA CPA-4924 form online.
- Click ‘Get Form’ button to obtain the IA CPA-4924 form and open it in your editing tool.
- In Part 1, fill in the information exactly as it appears on the original birth certificate. This includes the person's full name, date of birth, and place of birth, along with the names of the mother and father.
- Proceed to Part 2. Here, indicate the items that need to be amended. For each item, provide a description of the correction needed and include any supporting documents that validate the corrections.
- In Part 3, the applicant must sign the form in front of an authorized notary public. The notary will complete this section and affix their signature and seal.
- Ensure to provide a valid mailing address and daytime phone number in the designated fields, and check the applicable boxes for processing fees and copies needed.
- Gather all necessary supporting documents, certified copies, and payment methods for the processing fee. Ensure all documents are dated and relevant.
- Once all parts are completed and documents are prepared, submit the notarized form along with all supporting documents to the Iowa Department of Public Health.
- Finally, submit your request. Monitor the processing time, which typically takes about 15 days, and await confirmation of the amendment from the state.
Start completing your IA CPA-4924 form online today for an efficient amendment process.
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