580-0645 (3-2021) AFFIDAVIT FOR CORRECTION OF A BIRTH, DEATH, OR FETAL DEATH RECORD-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by reviewing the instructions carefully. Ensure all information is printed or typed clearly, identifying the certificate and the specific item(s) that need correction.
3. In the 'Identifying Vital Record to Correct' section, select whether you are correcting a birth, death, or fetal death record. Fill in the full name on record and date of birth or death.
4. Proceed to the 'Item(s) to Correct' section. For each item that needs correction, specify the item number or name, what it currently reads, and what it should read instead.
5. Complete the 'Affiant Information' section by providing your full name, relationship to registrant, mailing address, and phone number. Remember to sign in front of a notary public.
6. Finally, ensure all required documentary evidence is attached before submitting your completed affidavit to the Bureau of Vital Records.

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