Free Vs 24 C Form in PDF

Free Vs 24 C Form in PDF

The VS 24 C form, officially known as the Affidavit to Amend a Record, is a crucial document for correcting information on official records such as birth, death, or fetal death certificates in California. It mandates clear, black ink for entries and prohibits any form of erasures, whiteouts, photocopies, or alterations, ensuring that amendments are properly incorporated into the original record. If you need to correct details on an official record, click the button below to get started with filling out your form.

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In the intricate web of bureaucratic procedures that govern the amendments of vital records, the VS 24 C form stands out as a crucial document for individuals seeking to correct errors or make changes to birth, death, or fetal death records in the state of California. This form, officially known as the Affidavit to Amend a Record, serves as a gateway for legitimate corrections, ensuring the accuracy and integrity of one's personal history as recorded by state authorities. It is meticulously designed to prevent unauthorized alterations, stressing the importance of no erasures, whiteouts, photocopies, or alterations to the document itself. By requiring information to be typed or printed clearly in black ink only, the form ensures legibility and permanence of the amendments, which become an integral part of the official record. The process outlined in the VS 24 C form involves a detailed submission protocol, including the statement of corrections where individuals list each item that needs correction, accompanied by the incorrect and corrected information, followed by a reason for each correction. Signatures from two persons, certifying under penalty of perjury that they have personal knowledge of the facts, are mandatory to validate the affidavit. This methodical approach underscores the form's critical role in maintaining the integrity of vital records, simultaneously providing a clear, structured path for individuals to rectify inaccuracies that may have significant implications in their lives. Furthermore, the form's instructions signify the procedural and financial responsibilities involved in submitting an amendment application, highlighting the difference in requirements and fees based on the timing of the submission relative to the date of the event being corrected.

Preview - Vs 24 C Form

AFFIDAVIT TO AMEND A RECORD

_______________________________

NO ERASURES, WHITEOUTS, PHOTOCOPIES,

______________________________

STATE FILE NUMBER

 

OR ALTERATIONS

LOCAL REGISTRATION NUMBER

BIRTH

DEATH FETAL DEATH

 

TYPE OR PRINT CLEARLY IN BLACK INK ONLY – THIS AMENDMENT BECOMES AN ACTUAL PART OF THE OFFICIAL RECORD

PART I INFORMATION TO LOCATE RECORD

INFORMATION AS IT APPEARS ON CURRENT RECORD

 

1A. NAME—FIRST

1B. MIDDLE

 

 

 

1C. LAST

 

 

 

 

 

 

 

 

 

2. SEX

3. DATE OF EVENT—MM/DD/CCYY

4. CITY OF EVENT

 

5. COUNTY OF EVENT

 

 

 

 

 

 

 

 

6. FULL NAME OF PARENT AS STATED ON CURRENT RECORD

 

 

7. FULL NAME OF PARENT AS STATED ON CURRENT RECORD

 

 

 

 

 

 

 

 

PART II STATEMENT OF CORRECTIONS TO BIRTH, DEATH, OR FETAL DEATH RECORD

LIST ONE ITEM PER LINE

8.ITEM

NUMBER TO BE

CORRECTED

9. INCORRECT INFORMATION THAT APPEARS ON CURRENT RECORD

10. CORRECTED INFORMATION AS IT SHOULD APPEAR

REASON FOR CORRECTION

11.

AFFIDAVITS

AND

SIGNATURES

TWO

PERSONS

MUST SIGN

THIS FORM TO

CORRECT A

BIRTH, DEATH,

OR FETAL

DEATH

RECORD

We, the undersigned, hereby certify under penalty of perjury that we have personal knowledge of the above facts and that the information given above is true and correct.

12A. SIGNATURE OF FIRST PERSON12B. PRINTED NAME12C. TITLE/RELATIONSHIP TO PERSON IN PART I

12D. ADDRESS (STREET and NUMBER, CITY, STATE, ZIP)

 

12E. DATE SIGNED—MM/DD/CCYY

 

 

 

13A. SIGNATURE OF SECOND PERSON

13B. PRINTED NAME

13C. TITLE/RELATIONSHIP TO PERSON IN PART I

 

 

13D. ADDRESS (STREET and NUMBER, CITY, STATE, ZIP)

 

13E. DATE SIGNED—MM/DD/CCYY

STATE/LOCAL

REGISTRAR

USE ONLY

14. CDPH - VITAL RECORDS OR LOCAL REGISTRAR

15. DATE ACCEPTED FOR REGISTRATION

STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH - VITAL RECORDS

FORM VS 24 (REV. 04/20)

APPLICATION TO AMEND A RECORD

TYPE OR PRINT CLEARLY IN BLACK INK ONLY

NO ERASURES, WHITEOUTS, PHOTOCOPIES, OR ALTERATIONS

If an acceptable application to amend the record is registered within one year of the date of the event, there is no processing fee; however, there is a fee required for a certified copy.

Enclosed is the fee of $___________________________ for a certified copy of the newly amended record.

If an acceptable application to amend the record is registered one year or more after the date of the event, there is a fee for filing the affidavit, which includes one certified copy. There is a fee for each additional certified copy. Please contact your Local Registrar, County Recorder, or the State Registrar for the current fees, or visit our website at www.cdph.ca.gov.

Enclosed is the fee of $___________________________ for filing the affidavit and one certified copy of the newly amended record.

Enclosed is the fee of $___________________________ for an additional certified copy(ies) of the newly amended record.

______________________________________________

______________________________________________________________________

Printed Name of Applicant

 

Mailing Address of Applicant

Telephone Number (

) ________________________

______________________________________________________________________

Email Address: _________________________________

City, State, ZIP Code

 

GENERAL INFORMATION

1.The original certificate cannot be altered.

2.This amendment becomes a part of the original record, so please type or print clearly in black ink only.

3.Please submit original amendment form only. Photocopies of the amendment form will be rejected.

4.Your certified copy will include a copy of the original certificate with a copy of the amendment.

5.The certified copy of the certificate and the attached amendment must remain together for the certified copy to be valid.

READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE FORM

1.A Notarized Sworn Statement is required when requesting a certified authorized copy of the amended certificate. For more information please visit our website at www.cdph.ca.gov.

2.This form becomes a part of the original record – type or print clearly in black ink only.

3.No erasures, whiteouts, photocopies, or alterations allowed.

4.Complete Part I, Items 1 – 7, with the information as it appears on the current certificate.

5.Enter the certificate item number(s) to be corrected, either from the original or subsequent amendment, in Part II—Item 8. List one item per line.

6.Enter the incorrect information that appears on the current certificate in the line(s) provided below Item 9.

7.In Item 10, enter the correct information as it should appear for each item listed in Item 9.

8.Enter the reason for the correction in Item 11.

9.Read the affidavit statement. Two persons who are certifying to the statement of corrections must sign the form.

10.Do not write in Items 14 or 15. This space is reserved for State or Local Registrar use only.

11.Make check or money order payable to CDPH - Vital Records. When the paperwork is properly completed and signed by two parties, return this form, together with the required fee(s), to:

California Department of Public Health

Vital Records - Amendments - MS 5105

P.O. Box 997410

Sacramento, CA 95899-7410

Document Specs

Fact Detail
Purpose of Form Used to amend birth, death, or fetal death records in California.
Black Ink Requirement All entries must be made in black ink to ensure the amendment becomes an actual part of the official record.
No Alterations Allowed The form prohibits erasures, whiteouts, photocopies, or other alterations.
Affidavit Requirement Two persons must sign the form, certifying under penalty of perjury that the information is true and correct.
Fee Structure Fees vary depending on the timing of the submission relative to the date of the event recorded.
Governing Law California Department of Public Health - Vital Records, under the State of California regulations.
Processing Instructions Submit the original form with the applicable fee(s) to the California Department of Public Health Vital Records - Amendments.

Instructions on Writing Vs 24 C

Filling out the VS 24 C form is an essential step for individuals looking to amend a vital record in California. This form allows corrections to birth, death, or fetal death records to ensure accurate documentation. Careful completion of the form is required to avoid rejection of the application. Here's a detailed, step-by-step guide to assist you in this process:

  1. Begin by ensuring all information is entered using black ink, as the form clearly states that no other colors are acceptable.
  2. Identify the type of record you're amending by checking the appropriate box: Birth, Death, or Fetal Death.
  3. Following the sequence in Part I, input the information as it currently appears on the record, starting with the name (First, Middle, Last) in sections 1A, 1B, and 1C, respectively.
  4. Enter the sex of the individual in section 2.
  5. Provide the date of the event (birth, death, or fetal death) in section 3, using the MM/DD/CCYY format.
  6. Fill in the city and county of the event in sections 4 and 5.
  7. For sections 6 and 7, write the full names of the parents as stated on the current record.
  8. Move to Part II for corrections. Start by indicating the item number from the original certificate that needs correction in section 8.
  9. Enter the incorrect information that currently appears on the record in section 9.
  10. In section 10, write down the corrected information as it should correctly appear on the record.
  11. Provide the reason for each correction in section 11.
  12. Both first and second individuals amending the record must then read the affidavit statement, sign (sections 12A and 13A), print their name (sections 12B and 13B), mention their title/relationship to the person in Part I (sections 12C and 13C), and provide their address and the date signed (sections 12D, 12E, 13D, and 13E).
  13. Do not fill in the sections reserved for State/Local Registrar Use Only (Items 14 and 15).
  14. Include the applicable fee for filing the affidavit or for additional certified copies, if required. Make sure the check or money order is payable to CDPH - Vital Records.
  15. Review the completed form for accuracy and completeness to ensure it's free of erasures, whiteouts, photocopies, or alterations.
  16. Last, mail the completed form along with the required fee(s) to the address provided: California Department of Public Health Vital Records - Amendments - MS 5105, P.O. Box 997410, Sacramento, CA 95899-7410.

Remember, amendments registered within one year of the event date may not require a processing fee, but there's a fee for a certified copy. For amendments filed a year or more after the event, a filing fee will apply. This process, when followed correctly, ensures that the vital record reflects accurate and updated information.

Understanding Vs 24 C

What is the VS 24 C form used for?

The VS 24 C form is used to make amendments to a birth, death, or fetal death record in California. This form allows individuals to correct or change information that is incorrectly listed on the official record. It's important to follow the form's instructions carefully, as the amendment becomes a permanent part of the official record.

Who needs to sign the VS 24 C form?

Two persons with personal knowledge of the facts must sign the form. These individuals certify that the information they are providing, for the purpose of amending the record, is true and correct. Their relationship to the person on the record should be clearly stated, and they must provide their full names, titles or relationships, addresses, and the dates they signed the form.

Are there any fees associated with filing the VS 24 C form?

Yes, fees are associated with filing the VS 24 C form, though they vary depending on the timing of the amendment and the number of certified copies requested. If filed within one year of the event's date (birth, death, or fetal death), no processing fee is required; however, a fee for a certified copy of the amended record applies. If filed one year or more after the event, a filing fee that includes one certified copy is required. Additional copies incur extra fees. It's advisable to contact the Local Registrar, County Recorder, or the State Registrar for current fee information or visit the California Department of Public Health website.

Can the original certificate be altered?

No, the original certificate cannot be altered. The amendment form and the information provided on it become part of the original record but do not replace it. The certified copy of the record will include both the original certificate and a copy of the amendment.

What information is needed to complete the VS 24 C form?

To complete the VS 24 C form, you need information as it currently appears on the record and the correct information as it should appear after the amendment. This includes the full name of the individual on the record, date and place of the event (birth, death, or fetal death), and information regarding the parents, if applicable. Each item to be corrected must be listed with both the incorrect and correct information clearly stated, along with the reason for the correction.

Where should the completed VS 24 C form be submitted?

Once completed and signed, the form, along with any required fees, should be submitted to the California Department of Public Health Vital Records - Amendments. The mailing address is provided on the form itself. Ensure all parts of the form are filled out accurately and that no sections are altered or erased to avoid rejection.

Common mistakes

Many individuals encounter issues while completing the VS 24 C form due to a common mistake: failing to use black ink. The instructions clearly state that the form should be filled out in black ink only. This requirement ensures that the amendment is legible and permanent, as other colors might fade over time or not be as clearly photocopy-able for official records. This mistake can lead to the rejection of the amendment application, necessitating the time-consuming process of completing a new form.

Another frequent error is the presence of erasures, whiteouts, photocopies, or alterations on the form. The form's instructions prohibit these modifications explicitly because they can raise questions about the authenticity of the information provided. The use of these correction methods can suggest an attempt to alter the record improperly, thus resulting in the denial of the amendment. When mistakes are made, it's crucial to start over with a new form to ensure the integrity of the document.

It's also common for individuals to incorrectly complete Part I, specifically when entering the information as it appears on the current record. Accuracy in this section is critical, as it allows the registrar to locate the existing record in need of amendment. Errors or discrepancies in this information can prevent the correction from being applied to the correct record, leading to delays or outright rejection of the application.

Many individuals overlook the importance of listing one item per line in Part II, Item 8, for the corrections they wish to make. This oversight can lead to confusion and a lack of clarity about what changes are being requested. The form is designed for clear communication regarding each specific amendment, ensuring that each requested change is appropriately considered and applied. Failing to adhere to this structure can impede the amendment process.

Another error involves not providing a reason for the correction in Item 11. This section is critical for contextualizing the amendment request and justifying the need for a change. Without a clear, valid reason for the correction, the request might not meet the criteria for approval, leading to a denial. This step is essential for the integrity of vital records, ensuring changes are made for legitimate reasons.

Finally, a crucial mistake is not submitting the required fee with the form. This oversight can halt the processing of the amendment request. Whether the application is within one year of the event, thereby exempt from the processing fee but still requiring a fee for a certified copy, or if it's submitted one year or more after the event and subject to a filing fee, the correct amount must accompany the form. Failure to include this fee can delay or prevent the processing of the amendment application.

Documents used along the form

When attempting to amend a vital record, such as a birth, death, or fetal death record, the filing of the VS 24C form is a critical initial step. This form, known as the "Application to Amend a Record," is used to correct or update personal information on these significant documents. However, it often needs to be accompanied by additional forms and documents to ensure the amendment process is completed successfully and to support the information being amended. Here is an overview of some commonly required documents that may need to be filed along with the VS 24C form.

  • Proof of Identity: To amend a vital record, the applicant may be required to provide proof of their identity. This could include a government-issued photo ID, such as a driver's license or passport. The purpose of this requirement is to prevent identity theft and ensure that only authorized individuals can make changes to these sensitive records.
  • Supporting Documents: Depending on the nature of the amendment, various supporting documents may be required. For example, if a name is being corrected, legal documentation of the name change (such as a court order) may need to be submitted. These documents serve as verification of the information being added or corrected on the vital record.
  • Affidavit of Personal Knowledge: In cases where two individuals are attesting to the accuracy of the information to be amended (as mandated on the VS 24C form), an affidavit of personal knowledge may also be necessary. This legal document confirms that the individuals signing have direct knowledge of the facts related to the amendment request.
  • Notarized Sworn Statement: For certain amendments, particularly when requesting a certified copy of the amended record, a notarized sworn statement may be required. This statement testifies to the requester's identity and their entitlement to receive the certified copy, offering an additional layer of legal protection against fraud.
  • Payment of Fees: While not a document in the traditional sense, the submission of the appropriate fees is essential for the amendment process. This might include fees for filing the amendment, obtaining a certified copy of the amended record, or both. Details about the current fee structure are typically available on the website of the issuing authority or directly from their office.

Ensuring that all necessary forms and documents are correctly filled out and submitted alongside the VS 24C form is crucial for the timely and successful amendment of vital records. These documents not only support the validity of the requested changes but also protect the integrity of the official records and the privacy of the individuals involved. Should you have any questions or require assistance during this process, contacting your local registrar or the state department of vital records is advised.

Similar forms

The VS 24 C form is quite similar to the Application for a Social Security Card (Form SS-5) in several ways. Both forms require detailed and clear information about personal identity, including full names, date, and place of birth. They are designed to modify or establish official records, with the SS-5 being used for new, replacement, or amended Social Security cards. Like the VS 24 C, it becomes a part of the individual's permanent record. Both forms emphasize accuracy, with no room for alterations or errors, ensuring the integrity of personal records.

Another document similar to the VS 24 C form is the Passport Application Form (DS-11). This form, required for obtaining a U.S. passport, shares the emphasis on providing precise and unaltered personal details. Just like the VS 24 C form necessitates detailed information to amend a vital record, the DS-11 requires accurate personal information, evidence of citizenship, and identity to issue a passport. Both forms play a critical role in verifying and protecting personal identity and must be filled out with utmost accuracy.

The U.S. Visa Application (DS-160) also shares similarities with the VS 24 C form. Both documents demand comprehensive personal information and details about one’s background. The DS-160 is essential for those seeking to enter the United States temporarily, much like how the VS 24 C amends vital records crucial for legal identity verification. Accuracy and complete honesty are paramount in both forms to ensure the correct processing of the application.

The Application to Replace Permanent Resident Card (Form I-90) is akin to the VS 24 C form as well. Required for updating or replacing a Green Card, the I-90 form processes changes to an individual’s legal identification documents used within the U.S. immigration system. Both the I-90 and the VS 24 C emphasize the significance of providing current, accurate information for official records, involving identity and status changes.

A Birth Certificate Application is notably similar to the VS 24 C form in its purpose of recording and amending vital information. Though specific forms may vary by state, the core purpose of requesting a birth certificate involves providing detailed personal and parental information to authenticate an individual's birth in an official capacity. This process mirrors the VS 24 C's role in amending vital records, reinforcing the importance of precise and correct details in governmental records.

The Death Certificate Request form shares objectives with the VS 24 C form, particularly in its application to amend or correct official death records. Both types of documents require detailed information regarding the person(s) involved and the event (birth, death, fetal death) for accurate record-keeping. These forms are critical in legal and personal matters, affecting everything from estate settlements to personal identification records.

Dos and Don'ts

When completing the VS 24 C form, it is important to follow specific guidelines to ensure that the amendment to a record is processed efficiently and correctly. Below are listed things you should and shouldn't do when filling out this form.

Do:
  • Type or print clearly in black ink only. The amendment becomes an actual part of the official record; thus, clarity is crucial.
  • Complete Part I with information exactly as it appears on the current record. Accuracy in this section helps locate the record to be amended.
  • Enter one item per line in Part II when listing corrections. This helps in clearly identifying each correction to be made.
  • Provide the correct information as it should appear after the amendment. This ensures the record is updated accurately.
  • Include the reason for each correction in Part II. A clear explanation supports the necessity of the amendment.
  • Ensure two persons sign and date the affidavit. This verification step is crucial for the amendment process.
  • Prepare the payment correctly according to the instructions provided. Correct payment facilitates a smooth processing.
  • Contact your Local Registrar, County Recorder, or the State Registrar for current fees if needed. This ensures you have the most up-to-date information regarding costs.
Don't:
  • Use erasures, whiteouts, photocopies, or make alterations to the form. Such modifications can lead to the rejection of the application.
  • Detach the certified copy of the certificate from the attached amendment. Both documents must remain together for the certified copy to be valid.
  • Forget to provide a Notarized Sworn Statement if requesting a certified authorized copy of the amended certificate. This is a required document for processing.
  • Submit a photocopy of the amendment form. Only original forms are accepted.
  • Write in Items 14 or 15. These areas are reserved for State or Local Registrar use only.
  • Overlook the need for signatures from two persons certifying the statement of corrections. Their endorsement is necessary for validation.
  • Fail to include the required fee with your submission. Without the proper fees, the amendment process cannot proceed.
  • Use any ink color other than black. This requirement ensures readability and consistency in official records.

Misconceptions

When dealing with the process of amending a record, particularly using the form VS 24 C in California, several misconceptions can arise due to the form's specific requirements and the nature of official records amendment. To clarify, here is a breakdown of common misunderstandings:

  • Misconception 1: It's commonly thought that the original certificate can be physically altered or corrected when using the VS 24 C form. In reality, the original certificate remains unchanged; the amendment form is added to the existing record, preserving the initial document's integrity.
  • Misconception 2: Many assume that amendments to a vital record can be easily made by submitting photocopies of the VS 24 C form. The truth is, only original forms are accepted to ensure authenticity and reduce fraud risk.
  • Misconception 3: A widespread belief is that filling out and submitting the form is all that's required for the amendment to be processed. However, the form must be complemented by a notarized sworn statement for certified authorized copies of the amended certificate to be issued.
  • Misconception 4: There's a misunderstanding that any writing implement can be used to fill out the form. The form stipulates that all entries be made in black ink to ensure legibility and uniformity, minimizing the risk of misinterpretation.
  • Misconception 5: Another common error is thinking that correction requests can include erasures, whiteouts, or other forms of alterations. These are strictly prohibited to prevent tampering and ensure clarity in the request.
  • Misconception 6: Some people mistakenly believe there's a processing fee for the amendment no matter when it's submitted. If the amendment application is registered within one year of the event date, there's no fee for the amendment itself, although fees for certified copies still apply.
  • Misconception 7: It's erroneously thought that anyone can sign the amendment request. In fact, the form requires signatures from two individuals who have personal knowledge of the facts being corrected, certifying the truth of the information provided under penalty of perjury.
  • Misconception 8: Lastly, there's a belief that the VS 24 C form can be used to amend any detail on a vital record at any time. The form is designed for specific corrections, and certain items may require additional documentation or may not be amendable due to legal restrictions.

Understanding these intricacies is vital for anyone looking to accurately amend a record using the VS 24 C form. Ensuring all guidelines are followed can significantly streamline the amendment process, making it smoother for all parties involved.

Key takeaways

Understanding how to properly fill out and use the VS 24 C form is crucial for those needing to amend a vital record in California. Here are key points to keep in mind:

  • Type or print in black ink only to ensure that the amendment becomes an actual part of the official record without any issues.
  • The form prohibits erasures, whiteouts, photocopies, or alterations, maintaining the integrity of the original document and the amendment process.
  • Original certificates cannot be altered; instead, your amendment will be attached, forming part of the original record.
  • Submitting original amendment forms only is required, as photocopies of the amendment form will be automatically rejected.
  • Your certified copy will include both the original certificate and a copy of the amendment, which must remain together to be considered valid.
  • A notarized sworn statement is necessary when requesting a certified authorized copy of the amended certificate.
  • Items 1 through 7 in Part I require the information as it currently appears on the certificate to locate the record correctly.
  • In Part II, Items 8 through 11, clearly list the corrections, including the item number, incorrect information, corrected information, and the reason for each correction.
  • An affidavit statement must be signed by two persons who have personal knowledge of the corrections, certifying the truth and accuracy of the information provided.
  • Do not fill in Items 14 or 15; these are reserved for State or Local Registrar use only.

To successfully process an amendment, ensuring all information is accurate and adhering to the form's guidelines is essential. This includes providing a complete and precise reason for each correction, along with the correct payment for the accompanying fee(s), if required, depending on the timing of the submission relative to the date of the event. After proper completion, the form, together with the required fee(s), should be returned to the California Department of Public Health Vital Records - Amendments section.

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