What records can I request with this application?

The application has sections for birth, marriage, civil union, domestic partnership, and death records. Select the record type and provide the requested details.

What payment does the application list?

The form lists a charge of $10 per copy and says payment must be by money order payable to WNY Health Department.

Do I need a notary for the certified copy application?

No. This application is signed and dated without a notary. The form does not identify any notarized attachment.

How do I submit the application?

Mail or bring it to the West New York Health Department at 428 60th Street, Room 30, West New York, NJ 07093. Include the required money order and supporting items listed on the form.

West New York, MT · Hudson County

No notary required

Application for a Certified Copy of Vital Statistics

West New York residents use this application to request a certified copy of a birth, marriage, civil union, domestic partnership, or death record.

What this form is

The application requests a certified copy of a vital record and asks for the requester's contact information, relationship to the person on record, reason for the request, and record details. It includes sections for birth, marriage, civil union, domestic partnership, and death records. The form lists a $10 charge per copy, payable by money order only, and asks applicants to provide proof of relationship and acceptable identification.

Who needs it

A person requesting a certified copy of a birth, marriage, civil union, domestic partnership, or death record from West New York needs this application.

How to submit it

Mail or bring the completed application to the West New York Health Department, 428 60th Street, Room 30, West New York, NJ 07093. Include a money order payable to WNY Health Department; the form lists a $10 charge per copy.

About notarization

This application is signed and dated without a notary; the signer just signs and dates it, and the form does not identify any notarized attachment.

How to submit this form

1
Download The Application
Download the certified copy of vital statistics application.
2
Complete The Request
Fill in your contact information, relationship to the person on record, reason for the request, and details for the record type.
3
Gather Required Items
Include proof of relationship, acceptable identification, and a money order for $10 per copy payable to WNY Health Department.
4
Submit To The Health Department
Mail or bring the completed application and required items to the address listed on the form.

Frequently asked questions

What records can I request with this application?: The application has sections for birth, marriage, civil union, domestic partnership, and death records. Select the record type and provide the requested details.
What payment does the application list?: The form lists a charge of $10 per copy and says payment must be by money order payable to WNY Health Department.
Do I need a notary for the certified copy application?: No. This application is signed and dated without a notary. The form does not identify any notarized attachment.
How do I submit the application?: Mail or bring it to the West New York Health Department at 428 60th Street, Room 30, West New York, NJ 07093. Include the required money order and supporting items listed on the form.

Need something notarized?

This Application for a Certified Copy of Vital Statistics doesn’t need a notary — but if you have another West New York form that does, a commissioned online notary can help.