INSTRUCTIONS: APPLICATION TO CHANGE AN ALABAMA BIRTH OR DEATH CERTIFICATE (Form ADPH-HS-33)

To change information on an Alabama birth or death certificate, file the application discussed in this article. Known as form ADPH-HS-33, this document can be obtained from the website maintained by the Alabama Department of Public Health.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 1: The first section concerns changes to birth certificates. Check "Birth" if applicable.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 2: Enter the number of copies requested on the first blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 3: Enter the child's full name at birth on the second blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 4: Enter the child's date of birth on the third blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 5: Enter the child's country of birth on the fourth blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 6: Enter the hospital of birth on the fifth blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 7: Enter the father's full name on the sixth blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 8: Enter the mother's full maiden name on the seventh blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 9: On the eighth blank line, write the changes you are requesting.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 10: The next section concerns changes to death certificates. Check the box next to "Death" if applicable.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 11: Enter the number of copies requested on the first blank line.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 12: Provide all information requested about the deceased and the changes you are requesting.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 13: The last section concerns the applicant. Sign and print your name on the first two blank lines.

Application To Change An Alabama Birth Or Death Certificate ADPH-HS-33 Step 14: Provide all other information requested in this section and mail the form to the address given at the top of the page.

INSTRUCTIONS: ALABAMA ANNUAL AGENCY RECORDS DISPOSITION AUTHORITY (RDA) IMPLEMENTATION REPORT

The form discussed in this article is filed annually by Alabama agencies to document management of records. This document can be obtained from the website maintained by the Alabama Department of Archives and History.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 1: In the first blank box, enter the year covered.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 2: In the second blank box, enter the name of the agency.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 3: In the third blank box, enter the name of the agency records liaison.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 4: In the fourth blank box, enter the telephone number of the liaison.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 5: In the fifth blank box, enter the web site of the agency.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 6: Section I concerns general records management activies. Line A asks whether your agency has received training about records management from staff of the Department of Archives and History or other sources. Indicate your response with a check mark.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 7: Line B asks whether your agency provided in-house training to staff members regarding RDA implementation procedures and/or other records management related issues. Indicate your response with a check mark.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 8: Line C asks whether your agency has created or revised agency records management procedures or the manual for these procedures. Indicate your response with a check mark.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 9: Line D asks whether your agency has identified vital records, taken steps to protect them and if you have a disaster preparedness and recovery plan in place. Indicate your response with a check mark.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 10: Answer Lines E and F as instructed.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 11: Section II concerns the destruction of obsolete records. Answer all questions as instructed.

Alabama Annual Agency Records Disposition Authority (RDA) Implementation Report Step 12: Section III concerns the transfer of permanent records to the archives. Answer all questions as instructed.

INSTRUCTIONS: CONNECTICUT TPA ANNUAL REPORT CHECKLIST

An annual report should be filed by Connecticut third party administrators (TPA). This article discusses the checklist and report form, which can be obtained from the website of the government of Connecticut.

Connecticut TPA Annual Report Checklist Step 1: The first page contains the checklist. Check each box when you have met the requirements. Line 1 asks whether you have included a $100 filing fee payable to "Treasurer, State of Connecticut."

Connecticut TPA Annual Report Checklist Step 2: Line 2 asks if information in the annual report has been verified by at least two TPA officers.

Connecticut TPA Annual Report Checklist Step 3: Line 3 asks if you have included evidence of the required surety bond or audited financial statements for the two most recent years.

Connecticut TPA Annual Report Checklist Step 4: Line 4 asks if you have included the complete names and addresses of all insurers or other persons with whom the TPA had written agreements during the past year.

Connecticut TPA Annual Report Checklist Step 5: Line 5 asks if you have a current certificate of good standing from your domiciliary state.

Connecticut TPA Annual Report Checklist Step 6: Line 6 asks if you have included an explanation of any sanctions or administrative proceedings taken against your company in this or any other state.

Connecticut TPA Annual Report Checklist Step 7: Line 7 asks if you have included an explanation for any officer or director who has been convicted of a crime.

Connecticut TPA Annual Report Checklist Step 8: Line 8 asks if you have renewed your TPA license online prior to September 31.

Connecticut TPA Annual Report Checklist Step 9: Enter the trade or doing business as name of the TPA on the first blank line of the second page. 

Connecticut TPA Annual Report Checklist Step 10: Enter your Connecticut insurance department license number on the second blank line, your address on the next two blank lines, your telephone number on the fifth blank line and your email address on the sixth blank line.

Connecticut TPA Annual Report Checklist Step 11: Answer all remaining questions on the second page by checking "Yes" or "No" as applicable.

Connecticut TPA Annual Report Checklist Step 12: Up to two company officers and directors should sign and date the last page.