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Oregon Health Authority

Adding Child's First, Middle, & Last Names When Left Blank at Time of Birth

Submit the following with each request

  1. Birth certificate order form with full name of child/registrant listed with amended names. Include signature of applicant, photocopy of applicant’s ID, and fees for records.
    For ordering short form certificates, or for births occurring after 2008, please use this Birth record order form.
    For ordering full image/long form certificates for a birth occurring prior to 2008, please use this Full image birth record order form.
    OR
    Provide an order number or document showing certificate fees have already been paid and the order is uncompleted;
  2. Original notarized correction affidavit or supplemental report, if required per the chart below.
  3. $35 amendment fee, if required per the chart below.
  4. Original evidence document, if required per the chart below.

Amendments listed below are the most common amendments requested. If the change you need is not listed, please contact our staff for instructions.

Age of Person
Named on Record

Original Documents and
Signatures Required

Amendment and Record Fees

Child under age 1

Original Supplemental Report with notarized signatures of both parents if both are listed on the birth record.

No evidence document required.

No amendment fee

Certificate Fees

Child age 1 - 6

Original Birth Correction Affidavit with notarized signatures of both parents if both are listed on the birth record.

No evidence document required.

$35 amendment fee

Certificate Fees

Child age 7 - 17

Original Birth Correction Affidavit with notarized signatures of both parents if both are listed on the birth record.

Original evidence document at least five years old (or one year old if dated prior to 7th birthday) with full name, date of birth or age, and date document was created.

$35 amendment fee

Certificate Fees

Adult age 18 and over

Original Birth Correction Affidavit with notarized signature of person named on record.

Original evidence document at least five years old with full name, date of birth or age, and date document was created.

$35 amendment fee

Certificate Fees

Highlighting shows a difference in the requirements by age of registrant.

Amendments listed above are the most common amendments requested. If the change you need is not listed, please contact our staff for instructions.