Florida Regulations 64V-1.001: Delayed Birth Registration Requirements; Fees
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(1) All delayed birth registrations must be accompanied by an Application for Florida Delayed Certificate of Birth, DH Form 521 (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-07184, and the fee required by subsection (2), of Fl. Admin. Code R. 64V-1.014, and by documents described in subsection (2), of Fl. Admin. Code R. 64V-1.001, which substantiate the following facts of birth:
(a) Name at the time of birth of the registrant;
(b) Date of birth of the registrant;
(c) State of birth of the registrant as Florida;
(d) Mother’s/Parent’s name including her maiden surname; and,
(e) Father’s/Parent’s name; except that if the parents were not married at the time of the registrant’s birth, the father’s name shall not be entered on the delayed certificate except by an affidavit of acknowledgment of paternity signed by both parents before a notarizing official or two witnesses, or by order of a court of competent jurisdiction.
(2) The minimum requirements for documentary evidence are as follows:
(a) A statement that the birth actually occurred by an official of the hospital where the delivery occurred or where the registrant was admitted immediately after delivery, or
(b) If the registrant was not delivered in a hospital or admitted immediately after delivery or if hospital records are not available, a statement, based on professional case records of the event, by a Florida licensed physician, certified nurse midwife, Florida licensed midwife, or a public health nurse employed by the department; who attended the delivery, or
(c) Two supporting documents establishing birth facts contained in subsection (1), of Fl. Admin. Code R. 64V-1.001, except for item listed in paragraphs (1)(d) and (e), of Fl. Admin. Code R. 64V-1.001, for which only one document is required:
1. School record of registrant,
2. Social Security record of registrant,
3. Military record of registrant or military record of parent or guardian showing dependent data regarding the registrant,
4. Insurance policy application or personal history sheet,
5. Census records,
6. Other evidence on file in the Office of Vital Statistics taken from other registrations,
7. Medical treatment record for registrant,
8. Records maintained by the department or other state agency, State of Florida which substantiate the birth, or
9. Other verifiable records, except for those in subsection (6), of Fl. Admin. Code R. 64V-1.001
(3) Documentation required in paragraph (2)(c), of Fl. Admin. Code R. 64V-1.001, must have been established at least 5 years prior to filing unless applicant is under the age of 10. In such cases, the documents submitted must have been established at least 1 year prior to the date of filing for a delayed certificate.
(4) If documents listed in subsection (2), of Fl. Admin. Code R. 64V-1.001, cannot be obtained, the applicant may file for a delayed birth certificate under the provisions of Florida Statutes § 382.0195
(5) The Application for Florida Delayed Certificate of Birth, DH Form 521 (04/16), must be signed by a parent or guardian before a notarizing official for a registrant under the age of 18. A registrant 18 years or older, or if disability of nonage has been removed and the registrant provides proof of such removal, must sign this form before a notarizing official.
(6) Self serving affidavits and family bible records are not acceptable sources of primary documentary evidence but may be used to further substantiate the facts of birth.
(7) Documents submitted shall be in the form of an original record or duly certified copy thereof or a signed and certified statement from the custodian of the records. All documents submitted are subject to verification with the originating source.
(8) Delayed birth certificates issued pursuant to this section, except for clerical errors, cannot be amended without a court order.
(9) The state registrar or his or her designated representative shall abstract on the Delayed Certificate of Birth a description of each document submitted to support the facts shown on the delayed record. This description shall include:
(a) The title or description of the document;
(b) The date of the original filing of the document being abstracted; and,
(c) The information regarding the birth facts contained in the document.
(10) Applications for delayed certificates which have not been completed within 1 year from the date of the application shall be dismissed. Upon dismissal, the State Registrar shall so advise the applicant and all documents submitted in support of the delayed birth registration shall be returned to the applicant at last known address after review.
(11) Upon receipt of the required forms, fees and documentary evidence, the department shall electronically create and issue a Delayed Certification of Birth, DH Form 520, Nov. 07, hereby incorporated by reference and available from the Florida Department of Health, State Office of Vital Statistics, P.O. Box 210, Jacksonville, FL 32231-0042, and at https://www.flrules.org/Gateway/reference.asp?No=Ref-07185.
Rulemaking Authority 382.003(10), (11), 382.0255(3) FS. Law Implemented 382.003(7), (11), 382.019 FS. History-New 1-1-77, Formerly 10D-49.13, Amended 10-1-88, 10-1-90, 4-18-96, 12-26-96, Formerly 10D-49.013, Amended 11-11-98, 7-18-00, 2-29-04, 10-19-04, 5-13-08, 7-31-16.
Terms Used In Florida Regulations 64V-1.001
- Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
- Dependent: A person dependent for support upon another.
- Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
(b) Date of birth of the registrant;
(c) State of birth of the registrant as Florida;
(d) Mother’s/Parent’s name including her maiden surname; and,
(e) Father’s/Parent’s name; except that if the parents were not married at the time of the registrant’s birth, the father’s name shall not be entered on the delayed certificate except by an affidavit of acknowledgment of paternity signed by both parents before a notarizing official or two witnesses, or by order of a court of competent jurisdiction.
(2) The minimum requirements for documentary evidence are as follows:
(a) A statement that the birth actually occurred by an official of the hospital where the delivery occurred or where the registrant was admitted immediately after delivery, or
(b) If the registrant was not delivered in a hospital or admitted immediately after delivery or if hospital records are not available, a statement, based on professional case records of the event, by a Florida licensed physician, certified nurse midwife, Florida licensed midwife, or a public health nurse employed by the department; who attended the delivery, or
(c) Two supporting documents establishing birth facts contained in subsection (1), of Fl. Admin. Code R. 64V-1.001, except for item listed in paragraphs (1)(d) and (e), of Fl. Admin. Code R. 64V-1.001, for which only one document is required:
1. School record of registrant,
2. Social Security record of registrant,
3. Military record of registrant or military record of parent or guardian showing dependent data regarding the registrant,
4. Insurance policy application or personal history sheet,
5. Census records,
6. Other evidence on file in the Office of Vital Statistics taken from other registrations,
7. Medical treatment record for registrant,
8. Records maintained by the department or other state agency, State of Florida which substantiate the birth, or
9. Other verifiable records, except for those in subsection (6), of Fl. Admin. Code R. 64V-1.001
(3) Documentation required in paragraph (2)(c), of Fl. Admin. Code R. 64V-1.001, must have been established at least 5 years prior to filing unless applicant is under the age of 10. In such cases, the documents submitted must have been established at least 1 year prior to the date of filing for a delayed certificate.
(4) If documents listed in subsection (2), of Fl. Admin. Code R. 64V-1.001, cannot be obtained, the applicant may file for a delayed birth certificate under the provisions of Florida Statutes § 382.0195
(5) The Application for Florida Delayed Certificate of Birth, DH Form 521 (04/16), must be signed by a parent or guardian before a notarizing official for a registrant under the age of 18. A registrant 18 years or older, or if disability of nonage has been removed and the registrant provides proof of such removal, must sign this form before a notarizing official.
(6) Self serving affidavits and family bible records are not acceptable sources of primary documentary evidence but may be used to further substantiate the facts of birth.
(7) Documents submitted shall be in the form of an original record or duly certified copy thereof or a signed and certified statement from the custodian of the records. All documents submitted are subject to verification with the originating source.
(8) Delayed birth certificates issued pursuant to this section, except for clerical errors, cannot be amended without a court order.
(9) The state registrar or his or her designated representative shall abstract on the Delayed Certificate of Birth a description of each document submitted to support the facts shown on the delayed record. This description shall include:
(a) The title or description of the document;
(b) The date of the original filing of the document being abstracted; and,
(c) The information regarding the birth facts contained in the document.
(10) Applications for delayed certificates which have not been completed within 1 year from the date of the application shall be dismissed. Upon dismissal, the State Registrar shall so advise the applicant and all documents submitted in support of the delayed birth registration shall be returned to the applicant at last known address after review.
(11) Upon receipt of the required forms, fees and documentary evidence, the department shall electronically create and issue a Delayed Certification of Birth, DH Form 520, Nov. 07, hereby incorporated by reference and available from the Florida Department of Health, State Office of Vital Statistics, P.O. Box 210, Jacksonville, FL 32231-0042, and at https://www.flrules.org/Gateway/reference.asp?No=Ref-07185.
Rulemaking Authority 382.003(10), (11), 382.0255(3) FS. Law Implemented 382.003(7), (11), 382.019 FS. History-New 1-1-77, Formerly 10D-49.13, Amended 10-1-88, 10-1-90, 4-18-96, 12-26-96, Formerly 10D-49.013, Amended 11-11-98, 7-18-00, 2-29-04, 10-19-04, 5-13-08, 7-31-16.