Ariz. Admin. Code § R9-19-208 - Amending Information in a Registered Birth Record
A. A person requesting an amendment to an
individual's registered birth record shall include in a written request to
amend:
1. The individual's name currently in
the individual's registered birth record;
2. The individual's date of birth;
3. The name before first marriage of the
individual's mother;
4. If known,
the:
a. Individual's sex;
b. State file number;
c. Town or city of the individual's
birth;
d. County of the
individual's birth;
e. Hospital
where the individual was born, if applicable;
f. Name of the individual's father;
and
g. Dates of birth of the
individual's parents; and
5. The specific information in the
individual's registered birth record to be amended, including, as applicable or
as further specified in subsections of this Section, the specific information
to be deleted and the specific information to be added.
B. Except for an amendment specified in
another subsection of this Section, to request an amendment to an individual's
registered birth record, a person requesting the amendment shall submit to the
State Registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A);
b. The name and mailing address of the person
requesting the amendment;
c. The
relationship between the individual and the person requesting the amendment;
and
d. An affidavit attesting to
the validity of the submitted amendment, signed by the person requesting the
amendment;
2. A copy of a
court order to amend the individual's registered birth record, certified by the
issuing court and including the information to be amended, as specified
according to subsection (A)(5);
3.
If the person submitting the request for the amendment to the individual's
registered birth record is the individual's guardian, a copy of the court order
establishing guardianship, certified by the issuing court; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
C. An administrator of a hospital or the
person in charge of the medical records for the hospital where an individual
was born, who is requesting an amendment of information specified in
R9-19-201(A)(3) or (4) in the individual's registered birth record because of a
hospital error, shall submit to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A);
b. The name of the hospital administrator or
the person in charge of the hospital's medical records who is requesting the
amendment; and
c. A written
statement attesting to the validity of the submitted amendment, signed and
dated by the hospital administrator or the person in charge of the hospital's
medical records; and
2. A
copy of the part of the individual's or the individual's mother's medical
record containing the specific information to be amended.
D. A physician, registered nurse
practitioner, nurse midwife, or midwife who attended an individual's birth,
submitted a request for the individual's birth registration according to
R9-19-203, and requests an amendment of information specified in
R9-19-201(A)(3) or (4) in the individual's registered birth record because of
the physician's, registered nurse practitioner's, nurse midwife's, or midwife's
error shall submit to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A);
b. The name of the physician, registered
nurse practitioner, nurse midwife, or midwife who attended an individual's
birth; and
c. A written statement
attesting to the validity of the submitted amendment, signed and dated by the
physician, registered nurse practitioner, nurse midwife, or midwife who
attended the individual's birth; and
2. A copy of the part of the individual's or
the individual's mother's medical record containing the specific information to
be amended.
E. To add an
individual's first name, middle name, or suffix to the individual's registered
birth record 90 days or less after the individual's birth, the individual's
parent or guardian shall submit to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A), including the first name, middle name, or
suffix to be added;
b. The name and
mailing address of the individual's parent or guardian requesting the
amendment; and
c. An affidavit
attesting to the validity of the submitted amendment, signed, as applicable,
by:
i. Each parent whose name is included in
the individual's birth record, or
ii. The individual's
guardian;
2. If
the person submitting the request for the amendment to the individual's
registered birth record is the individual's guardian, a copy of the court order
establishing guardianship, certified by the issuing court; and
3. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
F. To add an individual's first name, middle
name, or suffix to the individual's registered birth record more than 90 days
but less than seven years after the individual's birth, the individual's parent
or guardian shall submit to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A), including the first name, middle name, or
suffix to be added;
b. The name and
mailing address of the individual's parent or guardian requesting the
amendment; and
c. An affidavit
attesting to the validity of the submitted amendment, signed, as applicable,
by:
i. Each parent whose name is included in
the individual's birth record, or
ii. The individual's
guardian;
2. An
evidentiary document that:
a. Includes the
first name, middle name, or suffix to be added; and
b. Was created within one year after the date
of the individual's birth;
3. If the person submitting the request for
the amendment to the individual's registered birth record is the individual's
guardian, a copy of the court order establishing guardianship, certified by the
issuing court; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
G. To request the amendment of an
individual's name in the individual's registered birth record 90 days or less
after the individual's birth, the individual's parent or guardian shall submit
to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A), including the specific name to be deleted
and the specific name to be added;
b. The name and mailing address of the
individual's parent or guardian requesting the amendment; and
c. An affidavit attesting to the validity of
the submitted amendment, signed, as applicable, by:
i. Each parent whose name is included in the
individual's birth record, or
ii.
The individual's guardian;
2. If the person submitting the request for
the amendment to the individual's registered birth record is the individual's
guardian, a copy of the court order establishing guardianship, certified by the
issuing court; and
3. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
H. To request the amendment of an
individual's name in the individual's registered birth record more than 90 days
but less than one year after the individual's birth, the individual's parent or
guardian shall submit to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A), including the specific name to be deleted
and the specific name to be added;
b. The name and mailing address of the
individual's parent or guardian requesting the amendment; and
c. An affidavit attesting to the validity of
the submitted amendment, signed, as applicable, by:
i. Each parent whose name is included in the
individual's birth record, or
ii.
The individual's guardian;
2. An evidentiary document that:
a. Includes the name to be added,
and
b. Was created within one year
after the date of the individual's birth;
3. If the person submitting the request for
the amendment to the individual's registered birth record is the individual's
guardian, a copy of the court order establishing guardianship, certified by the
issuing court; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
I. To amend the month or day of an
individual's birth in the individual's registered birth record, the individual,
if the individual is of legal age or is married, or the individual's parent or
guardian shall submit to the State Registrar or a local registrar:
1. A written request, in a
Department-provided format, that includes:
a.
The information in subsection (A), including the month or day to be deleted and
the month or day to be added;
b.
The name and mailing address of the individual or the individual's parent or
guardian requesting the amendment; and
c. An affidavit attesting to the validity of
the submitted amendment, signed, as applicable, by:
i. The individual;
ii. The individual's parent requesting the
amendment, whose name is included in the individual's birth record;
or
iii. The individual's
guardian;
2. An
evidentiary document that includes the requested month or day;
3. If the person submitting the request for
the amendment to the individual's registered birth record is the individual's
guardian, a copy of the court order establishing guardianship, certified by the
issuing court; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
J. To amend the date of birth or place of
birth of an individual's parent in the individual's registered birth record, to
change the individual's mother's last name in the individual's registered birth
record to the individual's mother's last name before the individual's mother's
first marriage, or to change the last name of the individual's father in the
individual's registered birth record, the individual, if the individual is of
legal age or is married, or the individual's parent or guardian shall submit to
the State Registrar or a local registrar:
1.
A written request, in a Department-provided format, that includes:
a. The information in subsection (A),
including the specific information in the individual's registered birth record
to be amended, including the date of birth, place of birth, or name to be
deleted and the date of birth, place of birth, or name to be added;
b. The name and mailing address of the
individual or the individual's parent or guardian requesting the amendment;
and
c. An affidavit attesting to
the validity of the submitted amendment, signed, as applicable, by:
i. The individual;
ii. The individual's parent requesting the
amendment, whose name is included in the individual's birth record;
or
iii. The individual's
guardian;
2.
One of the following evidentiary documents containing the specific information
for the individual's parent to be amended in the individual's registered birth
record:
a. A certified copy of the
individual's parent's registered birth certificate;
b. A copy of the individual's parent's
passport; or
c. A copy of an
administrative order or court order establishing paternity, certified by the
issuing entity;
3. If the
person submitting the request for the amendment to the individual's registered
birth record is the individual's guardian, a copy of the court order
establishing guardianship, certified by the issuing court; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
K. To request the amendment of an
individual's registered birth record based on the individual's biological
father's voluntary acknowledgement of paternity, the individual's mother and
biological father shall submit to the State Registrar:
1. A voluntary acknowledgement of paternity
form that complies with A.R.S. §
25-812;
2. The following information, which may be
submitted as part of the voluntary acknowledgement of paternity or in a
Department-provided format:
a. The information
in subsection (A);
b. The names and
mailing address of the individual's mother and biological father requesting the
amendment;
c. The following
information about the individual's biological father:
i. Name;
ii. Date of birth;
iii. State, territory, or foreign country
where the individual's biological father was born;
iv. Social Security Number;
v. Race;
vi. Whether the individual's father is of
Hispanic origin and, if so, the type of Hispanic origin; and
vii. Highest degree or level of education
completed by the individual's father at the time of the individual's
birth;
d. If the request
is submitted 90 days or less after the date of the individual's birth, the name
requested for the individual; and
e. If the request is submitted more than 90
days after the date of the individual's birth, the last name requested for the
individual;
3. If an
individual has a presumed father as described in A.R.S. §
25-814(A)(1),
a written document that contains:
a. The
individual's name;
b. The
individual's presumed father's name;
c. The individual's mother's name;
and
d. A jurat, as defined in
A.R.S. §
41-311,
signed by the individual's presumed father:
i. Attesting to the fact that, although the
individual's presumed father was married to the individual's mother, the
individual's presumed father is not the biological father of the individual;
and
ii. Relinquishing and waiving
all legal rights to the individual; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
L. To request the amendment of an
individual's registered birth record based on an administrative order or court
order establishing paternity, a person shall submit to the State Registrar:
1. A copy of the administrative order or a
court order establishing paternity, certified by the issuing entity;
2. The following information, which may be
submitted as part of the administrative order or a court order establishing
paternity or in a Department-provided format:
a. The information in subsection
(A);
b. The name and mailing
address of the person requesting the amendment; and
c. The following information about the father
to be added to the individual's registered birth record:
i. Name;
ii. Date of birth;
iii. State, territory, or foreign country
where the father was born; and
iv.
If the person requesting the amendment is not the issuing entity:
(1) Social Security Number;
(2) Race;
(3) Whether the father is of Hispanic origin
and, if so, the type of Hispanic origin; and
(4) Highest degree or level of education
completed by the father at the time of the individual's birth;
and
3. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
M. To request the amendment of the registered
birth record of an individual born in Arizona based on the individual's
adoption, a state court, the adopted individual's adoptive parent, the married
adopted individual, or the adopted individual of legal age shall submit to the
State Registrar:
1. A copy of the court order
of adoption, certified by the issuing court, or a certificate of adoption with
a court seal, after the individual's adoption is final;
2. If the document required in subsection
(M)(1) does not contain the following, the person who submitted the request to
amend the adopted individual's registered birth record shall submit to the
State Registrar:
a. The information in
subsection (A);
b. The name and
mailing address of the adopted individual's adoptive parent or the adopted
individual requesting the amendment;
c. The individual's name established by the
court order;
d. Whether the
individual's adoptive parents want the information about the individual's
parents currently in the individual's registered birth record to be
retained;
e. If the individual's
adoptive parents do not want the information about the individual's parents in
the individual's registered birth record before the adoption to be retained in
the individual's registered birth record after the adoption, the following
information:
i. The name and date of birth of
the individual's adoptive father;
ii. The state, territory, or foreign country
where the individual's adoptive father was born;
iii. The individual's adoptive father's
Social Security Number;
iv. The
name and date of birth of the individual's adoptive mother;
v. The individual's adoptive mother's last
name before first marriage;
vi. The
state, territory, or foreign country where the individual's adoptive mother was
born;
vii. The individual's
adoptive mother's Social Security Number;
viii. Street address, city or town, county,
and state of the individual's adoptive mother's residence at the time of the
individual's birth; and
ix. Street
address, city or town, county, and state of the individual's adoptive mother's
current residence;
f. If
the individual's adoptive parents want the information about the individual's
parents in the individual's registered birth record before the adoption to be
retained in the individual's registered birth record after the adoption, the
name and date of birth of each of the individual's adoptive parents;
g. Whether the individual's adoptive parents
want the name of the hospital, facility, or street address where the
individual's birth occurred to be omitted in the amended birth
record;
h. The signature of each of
the individual's adoptive parents and the date signed;
i. The name of the court issuing the document
required in subsection (M)(1); and
j. The date the final order of adoption was
granted;
3. If the
individual's adoptive parents want the information about the individual's
parents in the individual's registered birth record before the adoption to be
retained in the individual's registered birth record after the adoption:
a. A written request signed and dated by the
adoptive parent or a copy of a court order, certified by the issuing court,
containing a request to retain the information in the individual's registered
birth record;
b. Either:
i. A written statement with the notarized
signature of the individual's mother, agreeing to retain the mother's name in
the individual's registered birth record; or
ii. If the individual's mother is deceased, a
certified copy of a registered death certificate for the individual's mother;
and
c. If a father's
name is included in the individual's registered birth record, either:
i. A written statement with the notarized
signature of the individual's father, agreeing to retain the father's name in
the individual's registered birth record; or
ii. If the individual's father is deceased, a
certified copy of a registered death certificate for the individual's father;
and
4. The fee
in
R9-19-105 for a
request to amend information in a registered birth record.
N. If the State Registrar receives a court
order or a certificate of adoption with a court seal for an individual,
submitted as required in subsection (M), that names two persons of the same sex
as the individual's parents or the individual's mother and father, the State
Registrar shall enter the name of each person as the individual's parent in the
individual's birth record.
O. To
request an amendment to an individual's registered birth record when the
individual has undergone a sex change operation or has had a chromosomal count
that establishes the sex of the individual as different than in the
individual's registered birth record, an individual, if the individual is of
legal age or is married, or the individual's parent or guardian shall submit to
the State Registrar or a local registrar:
1.
A written request, in a Department-provided format, that includes:
a. The information in subsection (A),
including:
i. The individual's sex currently
in the individual's registered birth record, and
ii. The requested change for the individual's
sex to be included in the individual's registered birth
record;
b. The name and
mailing address of the individual or the individual's parent or guardian
requesting the amendment; and
c. An
affidavit attesting to the validity of the submitted amendment, signed, as
applicable, by:
i. The individual;
ii. The individual's parent requesting the
amendment, whose name is included in the individual's birth record;
or
iii. The individual's
guardian;
2. A
written statement on a physician's letterhead paper, signed and dated by the
physician, that the individual has:
a.
Undergone a sex change operation, or
b. Had a chromosomal count that establishes
the sex of the individual as different from that in the individual's registered
birth record;
3. If the
person submitting the request for the amendment to the individual's registered
birth record is the individual's guardian, a copy of the court order
establishing guardianship, certified by the issuing court; and
4. The fee in
R9-19-105 for a
request to amend information in a registered birth record.
P. The State Registrar or a local registrar
shall amend an individual's registered birth record based on:
1. A request for an amendment, if the State
Registrar or local registrar determines, according to
R9-19-103, that
the information and evidentiary documents in the request for amendment supports
the amendment of the individual's registered birth record; or
2. Except as provided in subsection (Q), a
court order.
Q. The State
Registrar or a local registrar shall not amend the date of birth in an
individual's registered birth record to a year later than the year in the date
currently stated in the individual's registered birth record if any of the
information in
R9-19-201, required for registering the individual's birth, was received by the State
Registrar or local registrar before the later date.
R. When the State Registrar or a local
registrar amends a registered birth record, the State Registrar or local
registrar shall seal the:
1. Registered birth
record that existed before the amendment, and
2. Evidentiary documents submitted to support
the amendment.
Notes
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