Florida Administrative Code › 64 - DEPARTMENT OF HEALTH › 64V - Vital Statistics › Chapter 64V-1 - VITAL RECORDS AND ASSOCIATED ACTIVITIES › Part IV - AMENDMENT OF DEATH AND FETAL DEATH CERTIFICATES › Section 64V-1.007 - Death and Fetal Death Certificate Amendments; Who May Apply; Fees; Documentary Evidence Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) Application
				  to amend items shall be submitted with an Application for Amendment to Florida
				  Death or Fetal Death Record, DH Form 524 (04/16), hereby incorporated by
				  reference and available from the Florida Department of Health, State Office of
				  Vital Statistics, P.O. Box 210, Jacksonville, Florida 32231-0042, and at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07199
,
				  and except for those items requiring the signature of the attending physician
				  or medical examiner as outlined in subsection (2), of Rule
				   64V-1.007, F.A.C., shall be
				  accompanied by the amendment fee required in subsection (3), of Rule
				   64V-1.014, F.A.C.
(2) Amendment of the medical certification of
				  the cause of death section, the date of death, hour or time of death, or the
				  place of death (other than street address) on a death certificate shall be
				  confirmed in writing by the certifying physician or the attending physician as
				  listed on the Florida Certificate of Death, DH 512 (04/16), or by the medical
				  examiner with current jurisdiction of the district in which the death occurred.
				  An Affidavit of Medical Amendment to Florida Certificate of Death, DH Form 434A
				  (04/16), hereby incorporated by reference and available from the Florida
				  Department of Health, State Office of Vital Statistics, P.O. Box 210,
				  Jacksonville, Florida 32231-0042, and at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07193
,
				  shall be completed and signed before a notarizing official by the certifying
				  physician or the attending physician as listed on the Florida Certificate of
				  Death, DH Form 512 (04/16), or by the medical examiner with current
				  jurisdiction of the district in which the death occurred. Such affidavit shall
				  be attached to the original death certificate. Amendment fees required pursuant
				  to paragraph (1)(c), of Section
				   382.0255, F.S., are waived in
				  such cases.
(3) Amendment of the
				  following items on a death certificate shall be made on an Affidavit of
				  Amendment to a Florida Certificate of Death, DH Form 433 (04/16), hereby
				  incorporated by reference and available from the department, and at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07181
.
				  Such affidavit shall be signed before a notarizing official by the informant or
				  next of kin and the funeral director except where such signature has been
				  waived by the department, pursuant to subsection (4), of Rule
				   64V-1.007, F.A.C., and shall
				  require the birth certificate of the decedent or two documents as referenced in
				  subsection (6), of Rule
				   64V-1.007, F.A.C., which were
				  established by the decedent. Documents submitted must be original, certified,
				  or notarized copies and must substantiate the facts to be amended and contain
				  the date the document was originally established:
(a) Name of decedent except that evidence is
				  not required for:
1. A misspelling,
2. A change to an initial as long as other
				  names of decedent are correctly entered and other personal identifying
				  information is correctly shown, or
3. The adding of a given name as long as
				  other names of decedent are correctly entered and other personal identifying
				  information is correctly shown.