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Fill Out Your Court Order To Amend A Wisconsin Birth Certificate Template

The Court Order To Amend A Wisconsin Birth Certificate form is a legal document used to request changes to an individual's birth certificate in Wisconsin. This petition allows individuals to correct inaccuracies in their birth records, ensuring that the information accurately reflects their identity. By following the necessary steps outlined in this form, petitioners can seek the amendments they need through the court system.

Fill Out Your Court Order To Amend A Wisconsin Birth Certificate Online

Fill Out Your Court Order To Amend A Wisconsin Birth Certificate Template

Structure

The Court Order to Amend a Wisconsin Birth Certificate form is a crucial document for individuals seeking to correct errors on their birth certificates. This process involves filing a petition that outlines the specific corrections needed, such as inaccuracies in personal information like names or dates. The form requires the petitioner to provide detailed information about the incorrect and correct entries, ensuring clarity for the court. Along with the petition, two copies of the Court Order are needed—one for the court file and another for the State Vital Records office. Additionally, the petitioner must include supporting evidence to substantiate the requested changes. To complete the filing, a fee of $164.50 must be paid to the Clerk of Court, along with any additional fees for amending the birth certificate and obtaining extra copies. This form not only serves to rectify personal records but also helps maintain accurate public records, which is essential for various legal and administrative purposes.

Form Example

PETITION FOR COURT ORDER

TO AMEND A WISCONSIN BIRTH CERTIFICATE

(used in conjunction with DPH 5091, Court Order to Amend a Wisconsin Birth Certificate)

Case Number: _______________________

Case Classification Code: 30708

PETITIONING PARTY INFORMATION:

Name: ___________________________________________________

Address: ___________________________________________________

City/State/ZIP ___________________________________________________

Phone No: ___________________________________________________

Petition is hereby being made to correct a birth certificate pursuant to Chapter 69.12, Wis. Stats. The correction(s) being requested to the original birth certificate are as follows:

1.Describe correction required: ________________________________________________

____________________________________________________________ and specify:

INCORRECT INFORMATION	CORRECT INFORMATION
______________________________	______________________________

2.Describe correction required: ________________________________________________

____________________________________________________________ and specify:

INCORRECT INFORMATION	CORRECT INFORMATION
______________________________	______________________________

3.Describe correction required: ________________________________________________

____________________________________________________________ and specify:

INCORRECT INFORMATION	CORRECT INFORMATION
______________________________	______________________________

Enclosed please find two (2) Court Orders to Amend a Wisconsin Birth Certificate (one for court file and one for State Vital Records office), along with the supporting evidence indicated on said Order.

Enclosed please find a check or money order payable to the Clerk of Court, in the amount of $164.50 to cover the filing fee for this action.

Also, enclosed please find a check or money order payable to the State of Wisconsin Vital Records, in the amount of $_________ to cover the fees associated with amending the original

birth certificate and for additional copies of the amended birth certificate as indicated on the back of the Court Order to Amend a Wisconsin Birth Certificate.

Date:____________________________________________________________

Signature of Petitioning Party

Enclosures: 2 Original Court Orders to Amend a Wisconsin Birth Certificate All supporting evidence (as indicated on Order)

Check payable to Clerk of Court (for filing fee)

Check payable to State of Wisconsin Vital Records (for amendment & copies)

Revised 09/09

➤ PDF File

Document Specs

Fact Name	Details
Purpose	This form is used to petition the court to amend a Wisconsin birth certificate, ensuring that the information accurately reflects the individual's identity.
Governing Law	The process is governed by Chapter 69.12 of the Wisconsin Statutes, which outlines the procedures for amending birth certificates.
Filing Fees	A filing fee of $164.50 is required, payable to the Clerk of Court. Additional fees may apply for amending the birth certificate and obtaining copies.
Supporting Documents	Petitioners must provide two original Court Orders to Amend a Wisconsin Birth Certificate and any supporting evidence as specified in the order.

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