Application Based on Parentage

Procedure to change a birth certificate
after an AOP has been properly finalized or a court order has established a father to a child
Once and AOP has been completed and received by the State Health Department Vital Statistics Unit from all parties of the AOP, you must complete an Application Based on Parentage form. This form is used to change, add, or remove the father to/from the birth certificate. Also you may change the child's last name with this form at the same time. The fee for filing is $25 and an additional $22, if you wish to receive the new birth certificate to be mailed to you.

The Application Based on Parentage form may also be used if their is a court order to add, remove, or change the father originally listed on the birth certificate. To change last name, once there is a court order, it must state so in the order.

You may come to our office from 8am-4pm for help with this form. We can fill it out for you and notarize your signature. Any questions please call us at 940-761-7802.

Application Based on New Parentage