Structure
The Michigan Application Birth form is an essential tool for individuals seeking to correct or change information on a birth record. This form is managed by the Michigan Department of Health and Human Services and serves a variety of purposes, from correcting minor details to making significant changes like legal name alterations. Applicants must provide clear and legible information, including their name, address, and contact details, to ensure smooth processing. Eligibility to request changes is limited to specific individuals, such as the person named on the record, a parent, or a legal guardian. The form outlines various types of changes that can be requested, ranging from correcting information for children under one year old to removing a non-biological parent from the record. Importantly, applicants must include supporting documentation, such as photo identification, to protect against identity theft. Fees for processing these requests are clearly stated, and applicants can expect a turnaround time of approximately 5-6 weeks, with options for expedited service available for an additional fee. Understanding the requirements and the process can make the journey to updating a birth record much smoother.
Form Example
APPLICATION TO CORRECT OR CHANGE A MICHIGAN BIRTH RECORD
Michigan Department of Health and Human Services
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For additional information: |
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MAIL APPLICATION AND PROPER FEE TO: |
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Vital Records Changes |
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www.Michigan.gov/VitalRecords |
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P.O. Box 30721 |
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Lansing MI 48909 |
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APPLICANT (PERSON REQUESTING CHANGE OR CORRECTION) |
PLEASE PRINT CLEARLY AND LEGIBLY |
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Applicant's |
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Name: |
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Address: |
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(Cannot send to General Delivery) |
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City/State: |
Zip: |
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Daytime Phone Required: ( |
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Notifications by email? Yes No |
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Email Address:
To protect from identity theft, PHOTO IDENTIFICATION must be presented along with this application. (See back for details)
ELIGIBILITY (Please check which category makes you eligible to request this change or correction)
To be eligible to correct or change a birth record, you must be the person named on the record and at least 18 years old, a parent named on the record, or a
copy of the court guardianship documents. Legally licensed representatives must provide information on official letterhead, documenting that he/she represents
the person named on the record and provide their state bar license number, along with client’s identification.
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Person named on the record |
□ Legal guardian of the person named on the record |
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(Must be at least 18 years old or legally emancipated) |
□ Legally licensed representative of the person named on the record |
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Parent named on the record |
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TYPE OF CHANGE OR CORRECTION REQUESTED |
(Please indicate below which type of change or correction you are requesting) |
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□Correct birth record information for a person under the age of 1 (one)
□Correct birth record information for a person age
□Correct birth record information for a person over the age of 6 (six)
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□Name change for parents who have married after the birth (marriage record required)
□Remove a person who is not the biological parent/father (court order required)
There is a separate application if you need to add a parent/father’s name to a birth record when there is no parent/father currently named on the record.
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INFORMATION NEEDED TO LOCATE BIRTH RECORD TO BE CHANGED |
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___________ |
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If any birth information is unknown, please indicate unknown |
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STATE FILE NUMBER (If known) |
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NAME |
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GENDER |
DATE OF BIRTH |
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AT |
First |
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Middle |
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Last |
□ Male |
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(mm/dd/yyyy) |
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BIRTH |
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□ Female |
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IF THE PERSON ON RECORD IS ADOPTED OR HAS HAD |
□ Adoption |
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A LEGAL NAME CHANGE (OTHER THAN MARRIAGE) |
□ Legal Name |
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PLEASE INDICATE THAT NAME HERE |
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Change |
First |
Middle |
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Last |
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PLACE OF |
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BIRTH |
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Hospital |
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City |
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County |
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PARENT/MOTHER'S |
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PARENT/FATHER'S |
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NAME BEFORE |
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NAME BEFORE |
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FIRST MARRIED |
First |
Middle |
Last |
FIRST MARRIED |
First |
Middle |
Last |
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SEE BACK FOR CURRENT FEES, PHOTO ID |
REQUIREMENTS AND PROCESSING TIMES |
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CHANGES REQUESTED: ITEM IN ERROR |
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INFORMATION AS IT SHOULD APPEAR |
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SIGNATURE(S) REQUIRED TO PROCESS APPLICATION. When two parents are named on the record, both parents’ signatures and current, valid photo identification are required to correct, add or change a child’s name, unless a court order of legal name change is supplied.
Signature of Person |
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Requesting Change |
Date |
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Other Signature |
Date |
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REQUIRED DOCUMENTATION
Changes or corrections to birth records that can be made by this office are limited by law and are subject to very specific supporting documentation. In general, you must include with this application, at least two (2) pieces of dated documentary evidence. To change any part of the name requires two documents dated close to the time of birth. (Exception: Only one document dated five years ago is required to correct the spelling of the first or middle name of the person named on the record). If you are requesting that the name on the record be changed due to a legal name change, only the court order is needed for documentation. If you need more information or have questions, you may call our Changes Unit direct at
PAYMENT - The fee for correcting or changing a Michigan birth record is $50.00 and includes one copy of the record with the changes made. Additional copies of the new record are available for $16.00 each when ordered at the same time. Payment must be by check or money order and made payable to the "State of Michigan."
PROCESSING TIME – Normal processing time for all changes or corrections will be
Application Fee |
$50.00 |
$ 50.00 |
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Fee includes one (1) certified copy of |
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the record |
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________ Additional Certified Copies |
$16.00 Each |
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Rush Fee |
$25.00 |
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TOTAL ENCLOSED |
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$ |
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PENALTIES: Any person who willfully and knowingly makes false application to change a Michigan birth record may be fined and/or imprisoned pursuant to MCL 333.2894(1)(b) and (c).
For Accounting Use Only
The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or
expression, political beliefs or disability.
Note: Applications sent to the Vital Records post office box with an
overnight delivery are not received in Vital Records for three (3) days.
PHOTO ID REQUIREMENTS FOR CHANGING OR CORRECTING
A MICHIGAN BIRTH RECORD
*Please Send Photocopies – Not Original Documents*
Under Michigan law, birth records are restricted documents. To request a birth record, a current valid, government issued identification is required to establish eligibility (except for an unrestricted birth record that is at least 100 years old). To protect from identity theft, a copy of the applicant’s government issued identification must be presented along with the application and fees.
Tier 1 Documentation that establishes identity by itself.
U.S. or Foreign Passport
U.S. Passport Card
U.S. or U.S. Territories Driver’s License or Identification Card
U.S. Military Identification Card with both picture and signature
Other U.S. or U.S. Territories issued document that meets the following criteria: Document must be unexpired. Document must contain a photograph and at least the following information: name, date of birth, date of expiration, signature, and address.
Tier 2 Documentation must include all documentation in one of the categories below:
Any of the documents in Tier 1 that expired within the past 5 years and any one document from Tier 3 issued within the past year.
Employment identification with photo, accompanied with a pay stub or
Student identification with photo, accompanied by a current report card or other proof of current school enrollment. Both documents must be for the same institution.
Department of Corrections identification card accompanied by probation or discharge papers issued within the past year.
If an inmate is currently incarcerated, a Department of Corrections identification card, accompanied by a verification of incarceration issued within the past year.
Tier 3 Documentation must include at least three alternative documents of different types from the list below, one must have been issued within the past year:
Any of the documents in Tier 1 expired more than 5 years.
Social Security Card (must be signed)
Marriage or Divorce certificate
Your child’s birth certificate
IRS form
Paycheck stub
Bank statement
Voter registration
Motor vehicle registration
Health insurance card
Utility Bill
Doctor/hospital/dentist bill
Religious/community organization documents, baptismal certificate
Military
School records
Letter/benefit statement from a government agency, like SSA or
IRS
Land or rental agreement
Military ID with either a picture or signature.
Other documents that establish identity to a degree equivalent to those listed above.
Document Specs
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| Governing Law | The Michigan Application Birth form is governed by MCL 333.2871(1) and MCL 333.2891(10). |
| Eligibility Criteria | Applicants must be at least 18 years old and either the person named on the record, a parent, or a legal guardian. |
| Required Documentation | At least two pieces of dated documentary evidence are needed to support any changes or corrections. |
| Application Fee | The fee for processing the application is $50. This includes one certified copy of the updated record. |
| Processing Time | Normal processing time is 5-6 weeks from the date all required documentation and payment are received. |
| Photo ID Requirement | A current valid photo ID must be submitted with the application to protect against identity theft. |
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