Correction of Birth Record - Fairfield County Court of Common Pleas, Probate Division

Case Number Day of hearing Month of hearing Year of hearing Name of person appearing Full Name of Child Place of Birth, city and county Date of Birth

Child's Gender

Male Female

Father's Name Mother's Maiden Name Father's Place of Birth Father's Age at Time of Birth Mother's Place of Birth Mother's Age at Time of Birth Item 1 info Item 1 reads as Item 1 should read Item 2 info Item 2 reads as Item 2 should read Item 3 info Item 3 reads as Item 3 should read