This form must be completed and returned to the Health Bureau of Vital Statistics at the later stages of the name change process for anyone that was born in the state of Florida. However, your county requires that it is completed and turned in early as part of the name change packet for the petition. We will remind you later in the process that you do not have to fill and print this form out again.
Please note: If the person changing their name was not born in the state of Florida, this form cannot be filled out and needs to be skipped (click the "Take Me To The Next Step" button below). If you were born in a state other than Florida, you must check with your state's department of health to determine what is required to amend your birth certificate. If you need help finding this information you can contact the Southern Legal Counsel.
We'll ask you one question at a time and your answers will fill out the Report of Legal Change of Name form. Then the form will be emailed to you.
Please note: If the person changing their name was not born in the state of Florida, this form cannot be filled out and needs to be skipped (click the "Take Me To The Next Step" button below). If you were born in a state other than Florida, you must check with your state's department of health to determine what is required to amend your birth certificate. If you need help finding this information you can contact the Southern Legal Counsel.
We'll ask you one question at a time and your answers will fill out the Report of Legal Change of Name form. Then the form will be emailed to you.
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