00 for each copy of the amended certificate requested. APPLICATION TO AMEND CERTIFICATE OF BIRTH STATE OF TEXAS NO. VITAL STATISTICS UNIT DEPARTMENT OF STATE HEALTH SERVICES P O BOX 12040 AUSTIN TEXAS 78711-2040 1-888-963-7111 This application supporting document s and the statutory filing fee of 15. 00 should be submitted to This fee does not include the cost of a certified copy of the record after the amendment is filed* Please enclose the additional fee of 22. Name Last First Middle Street Address Telephone 8am-5pm The penalty for knowingly making a false statement in this form can be 2-10 years in prison and a fine of up to 10 000. City State Zip Code Signature PART I. ENTER INFORMATION AS IT APPEARS ON THE ORIGINAL BIRTH CERTIFICATE* IF THE CHILD S NAME DOES NOT APPEAR ON BIRTH CERTIFICATE ENTER NOT SHOWN IN THE FIRST ITEM. Type or Print 1. FULL NAME OF CHILD 2. DATE OF BIRTH 3. PLACE OF BIRTH 4. SEX 5. STATE FILE NO. If known 6. FULL NAME OF FATHER 7. FULL MAIDEN NAME OF MOTHER P....
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How to fill out the TX VS-170 online
The TX VS-170 form is essential for correcting information on a birth certificate in Texas. This guide provides a step-by-step process to help users complete the form accurately and efficiently, ensuring that all necessary details are properly addressed for the correction request.
Follow the steps to fill out the TX VS-170 form correctly.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Fill in Section 1 with the applicant's information, including name, mailing address, email address, and phone number. Indicate the relationship to the person named on the birth certificate.
- In Section 2, enter the birth certificate information as it appears on the current document, including the birth certificate number, child's name, date of birth, sex, and place of birth.
- Section 3 requests specific corrections. Clearly list what you want to add, correct, or remove, supported by the information presently shown on the birth certificate.
- If adding or replacing a parent's name, complete Section 4 with the appropriate details about the new parent including names and birth places.
- In Section 5, indicate whether you would like a certified copy of the corrected birth certificate and specify the quantity and type.
- Finally, Section 6 requires signatures from the applicant and, if applicable, the second parent or legal guardian in the presence of a notary public. Ensure all information is accurate to prevent rejection of the application.
- After completing the form, review it thoroughly, ensure all sections are filled correctly, and save or print the document.
Start your online correction of documents today by following the steps provided.
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