The VS 24 C form, officially termed as the Affidavit to Amend a Record, is a crucial document used for making corrections to birth, death, or fetal death records in the state of California. It details a step-by-step process for requesting amendments, necessitating accurate information typed in black ink without any erasures, whiteouts, photocopies, or alterations, ensuring the integrity of the official record. Individuals seeking corrections must submit this form alongside affidavits and signatures from two persons verifying the authenticity of the corrections, highlighting the form's significance in maintaining the accuracy of vital records. Ready to make necessary corrections? Click the button below to start filling out your form.
Understanding the intricacies of official documentation can often be a daunting task, especially when it involves making amendments to vital records such as birth, death, or fetal death records. The Vs 24 C form, an Affidavit to Amend a Record, serves a crucial role in this process by providing a structured method for requesting updates or corrections to these sensitive documents. Described as an affidavit, this form requires the utmost accuracy and complete avoidance of erasures, whiteouts, photocopies, or alterations to maintain the integrity of the official record. It specifically demands that all information be typed or printed clearly in black ink, reinforcing the importance of clarity and legibility. Individuals seeking amendments must detail the current record's information, specify the incorrect details, and state the corrected information, ensuring the form comprehensively addresses the correction needs. Additionally, the requirement for affidavits and signatures from two individuals with personal knowledge of the facts underscores the form's emphasis on verification and authenticity. The process also includes a nuanced fee structure that varies depending on the timing of the amendment submission, which highlights the procedural aspects of making such requests. The comprehensive approach taken by the Vs 24 C form includes strict submission guidelines and is designed to maintain the official record's accuracy and reliability while accommodating necessary changes.
AFFIDAVIT TO AMEND A RECORD
_______________________________
NO ERASURES, WHITEOUTS, PHOTOCOPIES,
______________________________
STATE FILE NUMBER
OR ALTERATIONS
LOCAL REGISTRATION NUMBER
□ BIRTH
□ DEATH □ FETAL DEATH
TYPE OR PRINT CLEARLY IN BLACK INK ONLY – THIS AMENDMENT BECOMES AN ACTUAL PART OF THE OFFICIAL RECORD
PART I INFORMATION TO LOCATE RECORD
INFORMATION AS IT APPEARS ON CURRENT RECORD
1A. NAME—FIRST
1B. MIDDLE
1C. LAST
2. SEX
3. DATE OF EVENT—MM/DD/CCYY
4. CITY OF EVENT
5. COUNTY OF EVENT
6. FULL NAME OF PARENT AS STATED ON CURRENT RECORD
7. FULL NAME OF PARENT AS STATED ON CURRENT RECORD
PART II STATEMENT OF CORRECTIONS TO BIRTH, DEATH, OR FETAL DEATH RECORD
LIST ONE ITEM PER LINE
8.ITEM
NUMBER TO BE
CORRECTED
9. INCORRECT INFORMATION THAT APPEARS ON CURRENT RECORD
10. CORRECTED INFORMATION AS IT SHOULD APPEAR
REASON FOR CORRECTION
11.
AFFIDAVITS
AND
SIGNATURES
TWO
PERSONS
MUST SIGN
THIS FORM TO
CORRECT A
BIRTH, DEATH,
OR FETAL
DEATH
RECORD
We, the undersigned, hereby certify under penalty of perjury that we have personal knowledge of the above facts and that the information given above is true and correct.
12A. SIGNATURE OF FIRST PERSON12B. PRINTED NAME12C. TITLE/RELATIONSHIP TO PERSON IN PART I
►
12D. ADDRESS (STREET and NUMBER, CITY, STATE, ZIP)
12E. DATE SIGNED—MM/DD/CCYY
13A. SIGNATURE OF SECOND PERSON
13B. PRINTED NAME
13C. TITLE/RELATIONSHIP TO PERSON IN PART I
13D. ADDRESS (STREET and NUMBER, CITY, STATE, ZIP)
13E. DATE SIGNED—MM/DD/CCYY
STATE/LOCAL
REGISTRAR
USE ONLY
14. CDPH - VITAL RECORDS OR LOCAL REGISTRAR
15. DATE ACCEPTED FOR REGISTRATION
STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH - VITAL RECORDS
FORM VS 24 (REV. 04/20)
APPLICATION TO AMEND A RECORD
TYPE OR PRINT CLEARLY IN BLACK INK ONLY
NO ERASURES, WHITEOUTS, PHOTOCOPIES, OR ALTERATIONS
If an acceptable application to amend the record is registered within one year of the date of the event, there is no processing fee; however, there is a fee required for a certified copy.
Enclosed is the fee of $___________________________ for a certified copy of the newly amended record.
If an acceptable application to amend the record is registered one year or more after the date of the event, there is a fee for filing the affidavit, which includes one certified copy. There is a fee for each additional certified copy. Please contact your Local Registrar, County Recorder, or the State Registrar for the current fees, or visit our website at www.cdph.ca.gov.
Enclosed is the fee of $___________________________ for filing the affidavit and one certified copy of the newly amended record.
Enclosed is the fee of $___________________________ for an additional certified copy(ies) of the newly amended record.
______________________________________________
______________________________________________________________________
Printed Name of Applicant
Mailing Address of Applicant
Telephone Number (
) ________________________
Email Address: _________________________________
City, State, ZIP Code
GENERAL INFORMATION
1.The original certificate cannot be altered.
2.This amendment becomes a part of the original record, so please type or print clearly in black ink only.
3.Please submit original amendment form only. Photocopies of the amendment form will be rejected.
4.Your certified copy will include a copy of the original certificate with a copy of the amendment.
5.The certified copy of the certificate and the attached amendment must remain together for the certified copy to be valid.
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE FORM
1.A Notarized Sworn Statement is required when requesting a certified authorized copy of the amended certificate. For more information please visit our website at www.cdph.ca.gov.
2.This form becomes a part of the original record – type or print clearly in black ink only.
3.No erasures, whiteouts, photocopies, or alterations allowed.
4.Complete Part I, Items 1 – 7, with the information as it appears on the current certificate.
5.Enter the certificate item number(s) to be corrected, either from the original or subsequent amendment, in Part II—Item 8. List one item per line.
6.Enter the incorrect information that appears on the current certificate in the line(s) provided below Item 9.
7.In Item 10, enter the correct information as it should appear for each item listed in Item 9.
8.Enter the reason for the correction in Item 11.
9.Read the affidavit statement. Two persons who are certifying to the statement of corrections must sign the form.
10.Do not write in Items 14 or 15. This space is reserved for State or Local Registrar use only.
11.Make check or money order payable to CDPH - Vital Records. When the paperwork is properly completed and signed by two parties, return this form, together with the required fee(s), to:
California Department of Public Health
Vital Records - Amendments - MS 5105
P.O. Box 997410
Sacramento, CA 95899-7410
Filling out the VS 24 C form is a critical step in amending a vital record in California, whether for a birth, death, or fetal death record. This form allows for corrections to be officially made and becomes part of the original record. It's important to follow each step carefully to ensure the process goes smoothly and your request is processed without unnecessary delays. Here is a straightforward guide to help you complete the form accurately.
After submitting the VS 24 C form, the amendment process will take some time. The state department will review your submission, verify the information, and, if approved, issue an amended certificate. The certified copy of the amended certificate will then be sent to the address you provided. This copy, along with the amendment, must remain together at all times to be considered valid. Keep in mind, making official amendments to vital records is a significant process, so ensuring the accuracy and completeness of your submission can help avoid delays and additional fees.
The VS 24 C form, also known as the Affidavit to Amend a Record, is utilized to make corrections to a vital record in the state of California. This includes records pertaining to birth, death, or fetal death. It allows for the official amendment of personal details on these documents when incorrect information has been initially recorded.
Two individuals with personal knowledge of the facts needing correction must submit the VS 24 C form. They certify under penalty of perjury that the information they are providing for the amendment is true and correct. The individuals must indicate their relationship to the person on the record and their contact information.
The fees for filing a VS 24 C form vary depending on the timing of the amendment and the need for certified copies:
To correctly complete the VS 24 C form, the following information is necessary:
Yes, there are specific restrictions:
Upon processing the VS 24 C form, a certified copy of the amended record can be requested. This includes the original certificate along with the amendment. The certified copy and the amendment must remain together to be valid. An appropriate fee, as indicated by the California Department of Public Health or local agencies, is required for the certified copy.
Not all details on a vital record can be amended. Generally, corrections can be made to most informational errors. However, there are certain restrictions, especially concerning legal changes (e.g., name changes after adoption) that may require a court order or additional documentation. For specifics on what can be amended, it is advised to consult with the California Department of Public Health or a legal professional.
If an amendment request via the VS 24 C form is not accepted, the applicant will be notified by the California Department of Public Health or the local registrar's office. The notification will detail the reasons for rejection, which may include incomplete information, lack of necessary documentation, or non-compliance with prescribed guidelines. Applicants may have the opportunity to submit additional information or clarify discrepancies to fulfill the requirements for amending the record.
Filling out the form in an ink color other than black causes processing delays, as the form specifically instructs to type or print clearly in black ink only. This mistake might lead to the rejection of the application because the form also becomes an actual part of the official record, making legibility and adherence to instructions crucial.
Introducing erasures, whiteouts, or making alterations on the form is a common error. The instructions clearly prohibit these actions because they can compromise the integrity of the official record. Any mistake made while filling out the form should be addressed by starting anew on a clean form to avoid confusion and ensure the accuracy of the archives.
Submitting photocopies of the original amendment form instead of the original document itself is another mistake. The documentation requires original submissions as photocopies may not capture all details accurately, and original signatures are needed to verify the authenticity of the application.
Not completing Part I of the form with the information exactly as it appears on the current certificate can lead to the amendment being rejected. Accuracy in this section is vital for locating the original record that needs to be amended.
Only one item should be listed per line in Part II, Item 8, but often applicants list multiple corrections in one line. This mistake can cause confusion and potentially lead to only one of the requested amendments being processed.
Entering incorrect information in Item 9 (incorrect information that appears on the current record) or Item 10 (corrected information as it should appear) can significantly delay processing. It's essential to carefully review the current record and the correction being requested to ensure accuracy.
Failure to include the reason for correction in Item 11, or providing a vague explanation, can result in the amendment application being questioned or rejected. Clear and concise reasoning helps the assessing officer understand the necessity of the amendment, contributing to a smoother amendment process.
The requirement for two signatures on the amendment form underlines the seriousness of the amendment process. Overlooking or neglecting to have both parties sign the document is a critical error that will lead to the application's immediate rejection.
Forgetting to include the necessary fee(s) with the amendment form can halt the entire amendment process. Whether it's the processing fee for the application filed more than a year after the event or the fee for additional certified copies of the newly amended record, each has its specified amount that must be accurately enclosed.
Not using the correct mailing address when sending the amendment form and fees to the California Department of Public Health Vital Records can cause delays. Ensuring that the package is directed correctly is crucial for timely processing.
When working with the VS 24 C form, which is an affidavit to amend a record, various other forms and documents might be necessary to ensure that the amendment process is complete and the updated information is accurately reflected in the official records. These additional forms and documents complement the amendment process by providing required legal attestations, supporting evidence, or additional information that might be needed by the registrar. Understanding these documents helps streamline the amendment process, making it smoother and more efficient.
In the process of amending vital records such as birth, death, or fetal death certificates, the VS 24 C form serves as the core document. However, the accompanying documents listed above play crucial roles in supporting the amendment request. They provide legal and evidentiary support to ensure that all amendments are justified and properly documented. Whether it's providing proof of identity, legal authority, or the basis for the requested changes, each document helps safeguard the integrity of vital records.
The VS 24 C form, designed for amending vital records, bears similarity to the Application for a Social Security Card (Form SS-5). Both documents are used to correct or update personal information officially recorded by government agencies. The SS-5 form allows for the amendment of a Social Security record, including changes to a name or correcting the date of birth, mirroring the VS 24 C’s purpose of amending vital records such as birth, death, or fetal death certificates with accurate details. A pivotal aspect of both forms is their role in ensuring that government records accurately reflect individuals' personal information.
Another document resembling the VS 24 C form is the Passport Application Form (DS-11). This form is utilized when individuals need to apply for a new passport, including situations where amending existing information is necessary, such as changes in personal details due to marriage or legal name change. Like the VS 24 C, the DS-11 form requires detailed personal information and evidence to support the requested changes, emphasizing accuracy in official records and personal identification documents.
The Application for Marriage License in various states also aligns closely with the VS 24 C form's purpose. Similar to amending birth or death records, applying for a marriage license requires precise and current personal information. Both documents necessitate the submission of accurate details to official state records, underscoring the importance of legal documentation in personal identification and status within public records.
Lastly, the Driver License or Identification Card Application (Form DL-44) in California shares key characteristics with the VS 24 C form. Both forms are crucial for updating or correcting personal information with state agencies. The DL-44 form allows for changes to name, date of birth, and other personal details on a driver’s license or ID card, ensuring that these identifiers remain accurate and current, similar to the objectives of the VS 24 C form regarding vital records.
When completing the VS 24 C form, an affidavit to amend a record such as a birth, death, or fetal death certificate in the State of California, it's crucial to adhere to specific guidelines to ensure the amendment process is valid and error-free. Here’s a comprehensive guide:
Do's:
Don'ts:
When navigating the complexities of amending vital records, individuals often encounter misunderstandings about the process and requirements. The Affidavit to Amend a Record, known as the VS 24 C form, is essential in this procedure. Misconceptions about this form can lead to confusion and delays. Here, we aim to clarify and address these common errors.
Misconception 1: The original certificate can be altered.
Many believe that the original birth, death, or fetal death certificate can be directly modified. However, the VS 24 C form procedure does not alter the original certificate. Instead, any amendment made becomes a part of the original record, complementing it without changing the original document.
Misconception 2: Digital submissions are accepted.
A common assumption is that amendments can be submitted electronically. The instructions specify that only the original amendment form in black ink will be accepted, highlighting the requirement for physical documents over digital or copied submissions.
Misconception 3: Erasures, whiteouts, or photocopies are permitted.
There is a strict prohibition against erasures, whiteouts, photocopies, and alterations on the form. This rule ensures the integrity and clarity of the record amendment submission, which must be adhered to meticulously.
Misconception 4: Any witness can sign the affidavit.
The form specifies that two persons with personal knowledge of the corrected information must sign it. This is not just any witness but individuals who can certify the accuracy of the new details provided on the form.
Misconception 5: There is always a fee required to submit the form.
This misunderstanding ignores the stipulation that if an acceptable application to amend the record is registered within one year of the event date, no processing fee is charged for the amendment itself, though a fee for a certified copy may still apply.
Misconception 6: Amendments are processed immediately.
The processing of amendments can take time, and an immediate turnaround should not be expected. The form must first be submitted and accepted by the California Department of Public Health Vital Records or Local Registrar, a process involving verification and registration.
Misconception 7: Any type of ink can be used on the form.
The instructions specifically state that the amendment form should be filled out in black ink only. This requirement is to ensure legibility and uniformity in official records management.
Misconception 8: The amendment process is entirely online.
While some preliminary information might be available online, the VS 24 C form process involves filling out a physical document and mailing it with the appropriate fee to the California Department of Public Health Vital Records. This hybrid approach counters the belief that the process can be completed entirely online.
Misconception 9: Once amended, the original record is replaced.
A notable misconception is that the amendment process results in the original record being replaced or discarded. In reality, the amendment adds to the existing record, with both documents needing to remain together to reflect the complete and accurate history of the event.
Filling out and using the VS 24 C form, an Affidavit to Amend a Record, requires careful attention to detail and adherence to specific guidelines set by the California Department of Public Health - Vital Records. Here are key takeaways for a successful amendment process:
The process includes a fee structure that varies depending on the timing of the amendment submission relative to the date of the event recorded. These fees cover filing and obtaining certified copies, with specific amounts and additional copies carrying separate charges. This information, along with the completed form and necessary payment, should be directed to the California Department of Public Health Vital Records - Amendments section, ensuring the proper processing and amendment of vital records while maintaining their integrity and veracity.
Beneficiary Planning Guide - Ensure your personal details, from marital status to family structure, are clearly outlined, allowing your executor to navigate your wishes with a comprehensive perspective.
Living Will California - It includes a durable power of attorney for health care, designating someone to speak for the patient when they cannot speak for themselves.