"Request to Change Gender Designation on a Birth Certificate" - New Mexico

Request to Change Gender Designation on a Birth Certificate is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.

Form Details:

  • Released on October 1, 2019;
  • The latest edition currently provided by the New Mexico Department of Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Department of Health.

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Download "Request to Change Gender Designation on a Birth Certificate" - New Mexico

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Request to Change Gender
Designation on a Birth Certificate
rev. October 2019
Who may request a change?
An individual who was born in New Mexico, is 18 years of ago or older and wants to change the gender
designation on their birth certificate may request the change using this form.
What is required under NMSA 24-14-25?
The request form must be completed by a person requesting to change the gender designation on their birth
certificate
The request form must be signed in the presence of a Notary Public.
Applicable Fees
There is a $20 fee to amend the record and to change the name, if applicable, this fee includes one certified
copy of the new birth certificate. If you want additional certified copies of the new birth certificate, complete a
Birth Record Search Application
and include an additional $10 for each certified copy requested. Make check or
money order payable to New Mexico Vital Records.
Additional Information
If your full current legal name is different than the full name listed on your birth certificate, you must provide a
certified legal name change court order with this request form. If you want your full current legal name amended
on your birth certificate, indicate by checking the appropriate box. Additional proof documentation might be
requested. For information on legally changing your name, please visit our website at www.vitalrecordsnm.org.
Use by government agencies
At this time we are unsure if other agencies, such as Passport, will accept these amended certificates. For those
that include change of gender, nothing on the record will indicate a change was made. This will make it difficult to
connect the current record with the previous name on other documentation. In some cases, a court order might
be needed for full use of the new name and gender designation.
Submitting the form in person:
1105 S. St. Francis Drive Santa
Fe, NM 87505
8:30 a.m. – 4:00 p.m.
Mailing the form:
New Mexico Vital Records
PO Box 25767
Albuquerque, NM 87125
Phone: 1-866-534-0051
www.vitalrecordsnm.org
Web:
Request to Change Gender
Designation on a Birth Certificate
rev. October 2019
Who may request a change?
An individual who was born in New Mexico, is 18 years of ago or older and wants to change the gender
designation on their birth certificate may request the change using this form.
What is required under NMSA 24-14-25?
The request form must be completed by a person requesting to change the gender designation on their birth
certificate
The request form must be signed in the presence of a Notary Public.
Applicable Fees
There is a $20 fee to amend the record and to change the name, if applicable, this fee includes one certified
copy of the new birth certificate. If you want additional certified copies of the new birth certificate, complete a
Birth Record Search Application
and include an additional $10 for each certified copy requested. Make check or
money order payable to New Mexico Vital Records.
Additional Information
If your full current legal name is different than the full name listed on your birth certificate, you must provide a
certified legal name change court order with this request form. If you want your full current legal name amended
on your birth certificate, indicate by checking the appropriate box. Additional proof documentation might be
requested. For information on legally changing your name, please visit our website at www.vitalrecordsnm.org.
Use by government agencies
At this time we are unsure if other agencies, such as Passport, will accept these amended certificates. For those
that include change of gender, nothing on the record will indicate a change was made. This will make it difficult to
connect the current record with the previous name on other documentation. In some cases, a court order might
be needed for full use of the new name and gender designation.
Submitting the form in person:
1105 S. St. Francis Drive Santa
Fe, NM 87505
8:30 a.m. – 4:00 p.m.
Mailing the form:
New Mexico Vital Records
PO Box 25767
Albuquerque, NM 87125
Phone: 1-866-534-0051
www.vitalrecordsnm.org
Web:
Request to Change Gender
Designation on a Birth Certificate
CLEARLY PRINT OR TYPE INFORMATION. This request form must be signed in the presence of a Notary Public. See the
front page Information Sheet for instructions and further details. WARNING: Willfully providing a false statement to the
Department of Health for a certificate is a violation of New Mexico law. (NMSA 24-14-25).
Applicant’s Information
First name
Middle name
Last name
(as appears on Birth Certificate)
(as appears on Birth Certificate)
(as appears on Birth Certificate)
Full current legal name
Amend name on birth certificate?
(if different, submit certified legal name change court order)
Yes
No
Date of Birth
Place of Birth
(MM/DD/YYYY)
(City or County)
Father/ Parent 1 name as it appears on Birth Certificate
(First, Middle, Last)
Mother/ Parent 2 name as it appears on Birth Certificate, if applicable
(First, Middle, Last)
Mailing Address
(Address, City, State, ZIP code, Country)
Phone number
Email Address
(
)
-
What sex designation is currently shown on your birth certificate?..............................
Male
Female
X
What gender designation are you requesting to show on your birth certificate?.............
Male
Female
X
By signing and submitting this document to the Department of Health, you certify under penalty of perjury under the laws of
the State of New Mexico (NMSA 24-14-25) that the foregoing is true and correct.
Applicant ________________________________________________________________
Signed and sworn to before me on _______________ by __________________________
Void without
Signature of Notary Public __________________________________________________
Notary Seal here
My appointment expires ________________
Print Notary Name __________________________________
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