Ph 1673 Form PDF Details

The PH-1673 form serves a crucial role within the Tennessee Department of Health, Office of Vital Records, by facilitating a distinct and significant process: the creation of a new certificate of birth following the subsequent marriage of the child's parents. It entails a meticulous procedure that must be adhered to, starting with the completion based on the child’s original birth certificate information. Parents are required to affirm their statements under oath, attesting to their biological relationship to the child and the legitimacy of their marital union post the child's birth, as documented in dedicated sections of the form. This process is underscored by the necessity of a notarial endorsement, which validates the parents' declarations. Moreover, the instructions incorporated within highlight the conditional nature of this application, emphasizing scenarios in which a new certificate is warranted and detailing the administrative stipulations such as the mandatory inclusion of a certified marriage certificate, the requisites for documentation ink, and the pertinent fees. Furthermore, the guidelines caution against inaccuracies or alterations which could invalidate the form and elaborate on the subsequent immutable nature of the birth certificate post-issuance. Addressing the completion, filing, and regulatory compliance encapsulated in the application’s instructions, the PH-1673 form embodies an avenue for parents to legally acknowledge paternal ties and reflect changes in the child's familial status through the documentation of a new birth certificate.

QuestionAnswer
Form NamePh 1673 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesPH1673 blank birth certificate pdf tn 2008 form

Form Preview Example

TENNESSEE DEPARTMENT OF HEALTH

OFFICE OF VITAL RECORDS

APPLICATION FOR NEW CERTIFICATE OF BIRTH

BY SUBSEQUENT MARRIAGE OF PARENTS

Read instructions on the back before completing this form.

SECTION I

INFORMATION ON CHILD’S ORIGINAL BIRTH CERTIFICATE

 

 

 

Full Name of Child

 

 

 

 

 

 

 

 

 

First

Middle

Last

 

Date of Birth

 

 

Sex

 

 

 

 

Place of Birth

 

 

 

 

 

 

 

 

City

County

State

 

 

 

 

 

 

SECTION II

AFFIDAVITS OF PARENTS

 

 

 

I hereby certify, on oath, that I am the biological (natural) father of the child named in Section I and I was married to the mother of this child on_____________________________________ at _______________________________________.

DateCountyState

Father’s Signature __________________________________________________________________________________

Seal

Subscribed to and sworn before me this the _________ day of ________________________, 20_______

 

____________________________________ My commission expires _____________________, 20_______

 

Signature of Notary

I hereby certify, on oath, that I am the mother and that ______________________________________________________

is the biological (natural) father of the child named in Section I.Print Father’s Full Name

Mother’s Signature __________________________________________________________________________________

Seal

Subscribed to and sworn before me this the _________ day of ________________________, 20_______

 

 

 

 

____________________________________ My commission expires_____________________, 20_______

 

 

 

 

Signature of Notary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION III

 

 

 

INFORMATION FOR NEW CERTIFICATE

 

Full Name of Child _____________________ _______________________

_________________________________

 

(As it should appear on new certificate) First

Middle

 

 

 

 

Last

 

 

 

 

 

FATHER OF CHILD

 

 

 

 

 

 

MOTHER OF CHILD

 

Full Name

 

 

 

 

 

 

Full Legal Name

 

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

Maiden Surname

 

 

 

 

 

 

Birthplace

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

State or Foreign Country

 

 

 

 

 

 

 

 

 

 

Social Security Number

 

 

 

Social Security Number

 

 

Residential Address

 

 

Residential Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

State

Zip Code

City

State

Zip Code

PH-1673 (Rev. 05/15)

 

 

 

 

RDA 10112

INSTRUCTIONS

1.According to Tennessee Law (Tennessee Code Annotated 36-2-304) a man is presumed to be the father of a child if, after the child’s birth, he and the mother have married and he has consented in writing to be named the child’s father on the birth certificate. By completing this form and signing it in the presence of a notary public, the mother and the father agree the man is the father and that his name should be listed on the child’s birth certificate.

2.If any other man is already listed as the child’s father on the birth certificate, a court order must refute that man as father so that his name can be removed from the birth certificate.

3.If the man signing this application is already named as the father on the child’s birth certificate, a new birth certificate will not be prepared.

4.This is a legal form. Please read it and complete it carefully. Do not sign this form if you do not understand what it means.

5.Use black ink. Do not use any white out or erasures or the form will not be accepted.

Complete Section I with information that appears on the child’s original birth certificate.

Complete Section II under oath in the presence of a notary public.

In Section III enter the child’s name exactly as you want it to be shown on the child’s new birth certificate. The child’s given names (first and middle names) must remain as shown on the original birth certificate. The last name may be changed to that of the father. Provide the personal information about the parents to be entered on the child’s new birth certificate.

6.Return this application to:

TENNESSEE VITAL RECORDS OFFICE ANDREW JOHNSON TOWER, 1ST FLOOR 710 JAMES ROBERTSON PARKWAY NASHVILLE, TN 37243

Enclose a certified copy of the parents’ marriage certificate if the parents did not marry in Tennessee. If the parents were married in Tennessee within the past 50 years, you may enclose either a certified copy of the marriage certificate or information on the date and place of marriage so that staff can locate the marriage certificate.

Enclose a fee of $30.00 in the form of a check or money order made payable to Tennessee Vital Records for a certified long form copy of the new birth certificate. Additional copies are $15.00 each.

7.Once this form has been completed and filed with the Tennessee Vital Records Office, a court order will be required to make changes in the child’s name or make changes in the parentage of the child.

8.After the Tennessee Vital Records Office determines that this application form is complete, that the child has a Tennessee birth certificate, that no father is listed on the child’s birth certificate, and that the marriage certificate copy is acceptable, a new birth certificate will be prepared for the child. You will be sent the certified copies of the new birth certificate, which you ordered. This application form will be placed in a sealed file and cannot be opened or released except by court order.

9.If you have questions, contact the Tennessee Vital Records Office at (615) 532-2685.

PH-1673 (Rev. 05/15)

RDA 10112

How to Edit Ph 1673 Form Online for Free

Making use of the online tool for PDF editing by FormsPal, you can fill out or edit Ph 1673 Form right here. To keep our tool on the forefront of efficiency, we work to put into operation user-oriented capabilities and improvements on a regular basis. We're routinely grateful for any feedback - join us in remolding how we work with PDF docs. Here's what you'd have to do to get started:

Step 1: Open the form in our editor by clicking the "Get Form Button" above on this webpage.

Step 2: As soon as you open the online editor, you'll see the form ready to be filled out. Apart from filling in different fields, you might also perform several other actions with the PDF, namely putting on any text, modifying the original text, adding graphics, putting your signature on the form, and more.

With regards to the fields of this precise document, here is what you want to do:

1. Complete the Ph 1673 Form with a number of essential blanks. Gather all the required information and make certain there is nothing left out!

Simple tips to complete Ph 1673 Form step 1

2. Once your current task is complete, take the next step – fill out all of these fields - Subscribed to and sworn before me, SECTION III Full Name of Child, INFORMATION FOR NEW CERTIFICATE, Middle, Last, FATHER OF CHILD, Full Name Date of Birth Birthplace, City State Zip Code, MOTHER OF CHILD, Full Legal Name, Maiden Surname, Date of Birth, Social Security Number, Residential Address, and City State Zip Code with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Stage # 2 of filling in Ph 1673 Form

Lots of people generally make mistakes while completing Residential Address in this part. Make sure you revise everything you type in here.

Step 3: Be certain that your information is right and click on "Done" to continue further. Make a free trial plan with us and get immediate access to Ph 1673 Form - with all adjustments kept and accessible inside your personal account page. We don't sell or share the information that you enter when completing documents at our website.