Vs 23 Form - No erasures, whiteouts, photocopies, or alterations. 04/20) application to amend a birth record to reflect court order change of name. Web form vs 23 (rev. I hereby make application to amend the birth certificate for the individual identified. Type or print clearly in black ink only. Amend a california birth certificate to reflect a registrant’s name change, as granted by: The state office of vital records can mail this form to you if you ask for one at: O a court within california, another state, the district of columbia, or any territory
Type or print clearly in black ink only. Amend a california birth certificate to reflect a registrant’s name change, as granted by: 04/20) application to amend a birth record to reflect court order change of name. O a court within california, another state, the district of columbia, or any territory I hereby make application to amend the birth certificate for the individual identified. No erasures, whiteouts, photocopies, or alterations. The state office of vital records can mail this form to you if you ask for one at: Web form vs 23 (rev.