PETITION FOR CORRECTION OF BIRTH CERTIFICATE by few71840

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									Probate Court Form No. 200
Petition for Correction of
Birth Certificate

STATE OF VERMONT                                                    PROBATE COURT
DISTRICT OF ___________________


IN RE __________________________


                         PETITION FOR CORRECTION OF BIRTH CERTIFICATE


          TO THE HONORABLE PROBATE COURT FOR THE DISTRICT AFORESAID:

       Comes ________________________________________ of ____________________________ in the
County of _________________ and the State of Vermont, and respectfully represents that they were born in
the Town - City of __________________________ in the County of ____________________ and the State of
Vermont, on the _______________ day of ____________________ 20_____.

        That the record of their birth appears in the records of the Clerk=s Office of the Town - City of
______________________________ County of __________________________ and the State of Vermont, (a
copy of which is hereto attached) and


          That said record contains the following errors and omissions, viz:

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
_____________________________________________________________________

          That said erroneous facts and omission in said record should correctly appear as follows, to wit:

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
_____________________________________________________________________

         WHEREFORE, your petitioner prays that said court, after due notice and hearing, find the facts with
respect to the Record of Birth of your petitioner, issue a decree setting forth the facts found and fill out a
corrected Certificate of Birth in the usual form, and file such certificate with the Clerk of the Town - City of
________________________________, County of _______________________and State of Vermont,



          Dated: __________________________                 Signed _____________________________

                                                            Print Name: _________________________
                                                            Address: ____________________________
                                                            ____________________________________
                                                            Telephone: (____) ____________________

								
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