State of California ? Health and Human Services Agency Form to apply for a certified birth certifica Preview on Page 1

State of California ? Health and Human Services Agency Form to apply for a certified birth certifica 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the Applicant Information section. Enter today’s date, your printed name, and signature. Specify the purpose of your request and provide your mailing address.
  3. In the Birth Certificate Information section, accurately input the last, first, and middle names as they appear on the certificate. Include details such as city and county of birth, date of birth, and sex.
  4. Indicate whether the registrant has been adopted. If yes, follow the instructions provided regarding adoption.
  5. Complete the Sworn Statement if you are requesting a Certified Copy. Ensure it is notarized if submitting by mail.
  6. Submit payment of $14 for each copy requested. Include this with your application when mailing it to the Office of Vital Records.

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You would file a motion to amend the birth certificate through the clerk of the courts office in the county where you reside. You can also submit online to vital records.
You may be able to obtain a copy of the original birth certificate by filing a petition under California Health and Safety Code Section 102705 in the clerks office of the county superior court where you reside (if you live in California), or the county where the adoption was finalized.
To change or add a parents name to a birth certificate, complete the VS 21, Application to Amend a Birth Record-Adjudication of Facts of Parentage. Attach a certified copy of the court order, and a photocopy of the birth certificate.
If you want to change a parent who was listed on the childs original birth certificate, that must be done through the court system. This is referred to as an adjudication the court will decide (adjudicate) the existence or nonexistence of the parent and child relationship.
Claim for Disability Insurance (DI) Benefits (DE 2501) English: You must submit an original form provided by the EDD, either electronically or through US mail. It cannot be downloaded or reproduced. To submit the DE 2501 electronically, visit How to File a Disability Insurance Claim in SDI Online.

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