The form must be printed double-sided (one sheet not two).
Reported through: the clerk of the court to the State Vital Statistics Unit (VSU).
Clerk: print out the form and add the signature of the clerk of the court.
Sections 2 and 3: Section 2 (if applicable) is the report of divorce or annulment of marriage; Section 3 (if applicable) lists the children affected by this suit.
More children: if more than three children are affected, check the "additional children listed on back of form" box, and continue to list the additional children.
False information: Texas Penal Code, Section 37.10, specifies penalties for making false entries or providing false information in this document.
| Question | Answer |
|---|---|
| Form Name | VS-165 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 61 |
| Avg. time to fill out | 11 min |
| Edition | Rev 07/2017 |
| Issuing agency | Texas Department of State Health Services |
| Where to send | Through the clerk of the court to the State Vital Statistics Unit (VSU) |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | VS-165, VS165, Form VS-165, VS 165, Texas VS-165, Information on Suit Affecting the Family Relationship |
| Official source | VS-165 (Rev 07/2017), Texas Department of State Health Services |
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