APPLICATION TO AMEND CERTIFICATE OF BIRTH

APPLICATION TO AMEND CERTIFICATE OF BIRTH. Last First. Middle. Street Address: Street City/Town. State ZIP. Phone Number. Applicant's Signature. Relationship to Registrant. Part I: Information as Currently Shown on Birth Certificate. Last. Name of Child: First Middle. Date of Birth: Parish of Birth: State File Number: (if known) Part II: Items ...

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