Do I need a notary for the certified copy application?

No. This application is signed without a notary, and the form lists no notarized or sworn attachment.

How do I submit the certified copy application?

The form lists the West New York Health Department address at 428 60th Street, Room 30, West New York, NJ 07093. It offers pickup or mail delivery.

What payment does the form list?

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

West New York, MT · Hudson County

No notary required

Application for a Certified Copy of Vital Statistics

This Spanish-language application is for people requesting a certified copy of a vital statistics record from the West New York Health Department.

What this form is

Use this application to request a certified copy of a birth, marriage, civil union, domestic partnership, or death record. It asks for the record subject’s details, the requester’s relationship and contact information, the reason for the request, and the number of copies. The form lists a $10 charge per copy and requires a money order payable to WNY Health Department.

Who needs it

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

How to submit it

The form lists the West New York Health Department at 428 60th Street, Room 30, West New York, NJ 07093. It requires a $10 money order per copy payable to WNY Health Department and offers pickup or mail delivery.

About notarization

This application is signed without a notary; the signer just signs and dates it, and the form lists no notarized or sworn attachment.

How to submit this form

1
Download The Application
Download the Spanish-language application for a certified copy of vital statistics.
2
Complete The Form
Fill in the requested record, requester, contact, relationship, and copy information.
3
Gather The Listed Items
Include the required money order and the proof of relationship and acceptable identification listed on the form.
4
Submit To The Health Department
Use the address on the form; select pickup or mail delivery.

Frequently asked questions

Do I need a notary for the certified copy application?: No. This application is signed without a notary, and the form lists no notarized or sworn attachment.
How do I submit the certified copy application?: The form lists the West New York Health Department address at 428 60th Street, Room 30, West New York, NJ 07093. It offers pickup or mail delivery.
What does the application ask for?: It asks for details about the record and its subject, the requester’s relationship and contact information, the reason for the request, and the number of copies.
What payment does the form list?: The form lists a $10 charge for each copy and says payment must be by money order payable to WNY Health Department.

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.