Michigan PDF Forms

Michigan PDF Forms
Homepage > Fill Your Michigan Application Birth Template
Jump Links

Documents used along the form

When applying for changes or corrections to a birth record in Michigan, several other forms and documents may be required alongside the Michigan Application Birth form. Each of these documents serves a specific purpose in ensuring that the application process is thorough and compliant with state regulations. Below is a list of commonly used forms and documents that can accompany the application.

  • Photo Identification: A current, valid government-issued ID is essential to establish the applicant's identity. This could include a driver's license, passport, or military ID.
  • Court Guardianship Documents: If the applicant is a legal guardian, they must provide documentation that proves their guardianship status. This typically involves a court order.
  • Legal Name Change Order: For those requesting a name change on the birth record, a court order that legally confirms the name change is necessary.
  • Power of Attorney Document: If you need someone to act on your behalf in various matters while submitting your application, consider using a Power of Attorney form to empower your chosen representative.
  • Marriage Certificate: If a parent has married after the birth of the child, a marriage certificate is required to update the parent’s name on the birth record.
  • Documentary Evidence: At least two pieces of dated evidence are needed to support the requested changes. These documents should be close to the time of the birth and may include things like hospital records or affidavits.
  • Additional Copies Request Form: If the applicant wishes to obtain extra certified copies of the updated birth record, they must complete a request form and include the appropriate fees.
  • Payment Method: A check or money order made out to the "State of Michigan" must accompany the application to cover the fees for processing the change.

Gathering these documents in advance can streamline the application process and help ensure that all necessary information is submitted correctly. Being well-prepared not only saves time but also increases the chances of a smooth and successful application experience.

Michigan Application Birth Preview

APPLICATION TO CORRECT OR CHANGE A MICHIGAN BIRTH RECORD

Michigan Department of Health and Human Services

 

For additional information:

 

 

MAIL APPLICATION AND PROPER FEE TO:

 

517-335-8660

 

 

Vital Records Changes

 

www.Michigan.gov/VitalRecords

 

 

P.O. Box 30721

 

 

 

 

Lansing MI 48909

 

APPLICANT (PERSON REQUESTING CHANGE OR CORRECTION)

PLEASE PRINT CLEARLY AND LEGIBLY

 

Applicant's

 

 

 

 

Name:

 

 

 

 

Address:

 

 

 

 

(Cannot send to General Delivery)

 

City/State:

Zip:

 

Daytime Phone Required: (

)

Notifications by email? Yes No

 

 

 

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 court-appointed legal guardian or legally licensed representative of the person named on the record. Legal guardians must include 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.

 

□

Person named on the record

□ Legal guardian of the person named on the record

 

□

(Must be at least 18 years old or legally emancipated)

□ Legally licensed representative of the person named on the record

 

Parent named on the record

 

TYPE OF CHANGE OR CORRECTION REQUESTED

(Please indicate below which type of change or correction you are requesting)

 

 

 

 

□Correct birth record information for a person under the age of 1 (one)

□Correct birth record information for a person age 1-5 (one to five)

□Correct birth record information for a person over the age of 6 (six)

□Court-ordered legal name change (court order required)

□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.

 

 

INFORMATION NEEDED TO LOCATE BIRTH RECORD TO BE CHANGED

_ ___

___________

 

 

 

If any birth information is unknown, please indicate unknown

 

STATE FILE NUMBER (If known)

 

 

NAME

 

 

 

 

 

GENDER

DATE OF BIRTH

 

 

AT

First

 

Middle

 

Last

□ Male

 

(mm/dd/yyyy)

 

 

BIRTH

 

 

□ Female

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF THE PERSON ON RECORD IS ADOPTED OR HAS HAD

□ Adoption

 

 

 

 

 

 

 

A LEGAL NAME CHANGE (OTHER THAN MARRIAGE)

□ Legal Name

 

 

 

 

 

 

 

PLEASE INDICATE THAT NAME HERE

 

Change

First

Middle

 

Last

 

 

PLACE OF

 

 

 

 

 

 

 

 

 

 

BIRTH

 

Hospital

 

 

City

 

County

 

 

 

 

PARENT/MOTHER'S

 

 

 

PARENT/FATHER'S

 

 

 

 

 

 

NAME BEFORE

 

 

 

NAME BEFORE

 

 

 

 

 

 

FIRST MARRIED

First

Middle

Last

FIRST MARRIED

First

Middle

Last

 

 

 

 

SEE BACK FOR CURRENT FEES, PHOTO ID

REQUIREMENTS AND PROCESSING TIMES

 

 

 

 

 

CHANGES REQUESTED: ITEM IN ERROR

 

INFORMATION AS IT SHOULD APPEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

Requesting Change

Date

 

 

Other Signature

Date

 

 

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 517-335-8660.

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 5-6 weeks from the date all documentation, payments and photo ID are received in the State Vital Records Office. Two-three week rush processing is available for an additional fee.

Application Fee

$50.00

$ 50.00

(Non-Refundable)

 

 

Fee includes one (1) certified copy of

 

 

the record

 

 

________ Additional Certified Copies

$16.00 Each

$

Rush Fee

$25.00

$

 

 

 

TOTAL ENCLOSED

 

$

 

 

 

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.

DCH-0847-CHGBX Rev 8-2021 MCL 333.2871(1) and 333.2891(10)

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.

--OR (If you do not have a document from Tier 1)

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 W-2 form issued within the past year.

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.

--OR (If you do not have documents from Tier 1 or 2)

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 W-2

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 DD-214 discharge paper or equivalent

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.

Similar forms

  • Birth Certificate Application: Similar to the Michigan Application Birth form, a birth certificate application is used to request an official record of a person's birth. Both require personal information, proof of identity, and eligibility criteria to be met.
  • Marriage License Application: This document is used to apply for a marriage license. Like the birth form, it requires identification and verification of eligibility, such as age and residency.
  • Death Certificate Application: A death certificate application requests an official record of a person's death. Both forms require identification and specify who is eligible to request the document.
  • Social Security Card Application: This application is used to request a Social Security card. Similar to the birth form, it requires proof of identity and eligibility, ensuring the correct person receives the card.
  • Small Estate Affidavit: To facilitate the transfer of assets for estates below a certain value, consider using the necessary Small Estate Affidavit form to simplify the process for heirs.
  • Change of Name Application: This document is used to legally change a person's name. Like the Michigan Application Birth form, it requires proof of identity and often documentation supporting the name change.
  • Passport Application: A passport application requests a passport for international travel. Similar to the birth form, it requires proof of identity, citizenship, and often a fee.
  • Voter Registration Application: This document registers a person to vote. It shares similarities with the birth form in that it requires proof of identity and eligibility, such as age and residency.
  • Adoption Application: This application is used to initiate the adoption process. Like the birth form, it requires documentation proving eligibility and identity, ensuring the right individuals are involved.
  • Driver’s License Application: This document requests a driver’s license. Similar to the birth form, it requires identification and proof of residency, ensuring that the applicant meets the necessary qualifications.

More PDF Documents

Michigan Molina Prior Authorization - The member's phone number should be included for potential follow-up communication.

A Georgia Lease Agreement form is a legally binding document that outlines the terms and conditions between a landlord and a tenant for renting residential or commercial property. This form serves to protect the rights of both parties while ensuring clear communication regarding rental payments, property maintenance, and other essential responsibilities. For more information on the requirements and details of the agreement, you can visit Forms Georgia. Understanding its components is crucial for anyone entering into a rental agreement in Georgia.

Sales Tax License Michigan Application - Current IFTA license jurisdictions must be listed to clarify the applicant's tax compliance status.

Michigan Nonprofit - Using the correct form number is crucial to ensure that filings are processed efficiently.

Misconceptions

  • Myth 1: Anyone can request a change to a birth record.

    • Only specific individuals are eligible to request changes. This includes the person named on the record, a parent, or a court-appointed legal guardian. Others cannot make requests without proper authorization.

  • Myth 2: A birth record can be changed for any reason.

    • Changes must be based on valid reasons, such as correcting errors or updating information due to a legal name change. Unsupported requests will not be processed.

  • Myth 3: You can submit the application without any identification.

    • Photo identification is required to protect against identity theft. Applications without proper ID will not be accepted.

  • Myth 4: The processing time is always quick.

    • Normal processing times can take 5-6 weeks. If you need faster service, a rush option is available for an additional fee.

  • Myth 5: You do not need to provide any documentation to support your request.

    • At least two pieces of dated documentary evidence are generally required. This is crucial for verifying the requested changes.

  • Myth 6: You can change a name on the record without a court order.

    • A court order is necessary for a legal name change. This ensures that all changes are legally recognized.

  • Myth 7: There are no fees associated with changing a birth record.

    • A fee of $50.00 is required for processing changes, which includes one certified copy of the updated record. Additional copies incur extra charges.

  • Myth 8: You can send your application via general delivery.

    • Applications must be sent to a specific address and cannot be sent via general delivery. This ensures timely processing and receipt.

Detailed Instructions for Using Michigan Application Birth

Once you have gathered the necessary information and documents, you can begin filling out the Michigan Application Birth form. This process requires careful attention to detail to ensure all information is accurate and complete. Follow these steps to successfully complete the form.

  1. Print the form: Obtain a copy of the Michigan Application Birth form from the Michigan Department of Health and Human Services website or any authorized location.
  2. Fill in your personal information: In the "Applicant" section, clearly print your name, address, city, state, zip code, and daytime phone number. Provide your email address if you wish to receive notifications via email.
  3. Check eligibility: Indicate your eligibility by checking the appropriate box. You can be the person named on the record, a parent, a legal guardian, or a legally licensed representative.
  4. Specify the type of change: In the section for "Type of Change or Correction Requested," check the box that corresponds to the change you are requesting.
  5. Provide birth record information: Fill in the name, gender, and date of birth of the person on the record. If applicable, indicate if the person was adopted or has had a legal name change.
  6. Complete the place of birth: Enter the hospital name, city, and county where the birth occurred.
  7. List parents' names: Provide the names of the mother and father as they appeared before marriage.
  8. Request changes: In the "Changes Requested" section, clearly specify the items that are incorrect and how they should appear after correction.
  9. Sign the application: Both parents must sign if they are named on the record. Include the date of signature.
  10. Gather required documentation: Collect at least two pieces of dated documentary evidence to support your request. Ensure you have the necessary photo ID as specified.
  11. Prepare payment: Include a check or money order for the application fee of $50, made payable to the "State of Michigan." If you are requesting additional copies, include the appropriate fees.
  12. Mail the application: Send the completed application, documentation, and payment to the address provided on the form.

After submitting your application, the processing time typically takes 5-6 weeks. If you opted for rush processing, expect a quicker turnaround for an additional fee. Keep your receipt and any tracking information for your records. If you have questions, don't hesitate to reach out to the Changes Unit for assistance.

Dos and Don'ts

When filling out the Michigan Application Birth form, follow these guidelines:

  • Print all information clearly and legibly to avoid processing delays.
  • Include your current, valid photo identification as required by law.
  • Ensure that you are eligible to request the change or correction based on the specified criteria.
  • Double-check the fees and ensure payment is included with the application.

Additionally, avoid the following common mistakes:

  • Do not submit original documents; only photocopies are accepted.
  • Avoid using a General Delivery address for mailing your application.
  • Do not forget to sign the application; both parents' signatures are needed if applicable.
  • Do not leave any required fields blank; incomplete applications may be rejected.