Manchester Township, NJ · Ocean County
Delegation of Authority to Receive Certified Copy of Vital Record
This form lets an authorizing person designate someone to obtain certified copies of a birth or death record on their behalf from the New Jersey Department of Health.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Use this form to give another person written authority to obtain certified copies of a birth or death record on your behalf. It asks for information about the authorizing person, authorized individual, and record, including the event date and location and both parents’ names. The form states that the authorizing person must sign and date it before a notary, and that the authorized individual must provide valid identification.
Who needs it
A person who wants to authorize someone else to obtain certified copies of their birth or death record needs to complete this form.
Why it needs a notary
The form has a sworn-to-before-me jurat; the authorizing person signs and dates the statement in the notary’s presence.
How to get this notarized
- 1
Download The Form
Get the Delegation of Authority to Receive Certified Copy of Vital Record form.
- 2
Fill In The Details
Enter the authorizing and authorized individuals’ names and the requested birth or death record information.
- 3
Book An Online Notary
Arrange a notarization appointment before signing the statement.
- 4
Sign On Video
Sign and date the form in the notary’s presence during your online appointment.
- 5
Submit The Form
Send the completed form to the New Jersey Department of Health at the address printed on it.
Preview the form
The blank PDF straight from Manchester Township. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I authorize someone to receive a certified vital record?
- Complete the delegation form with your details, the authorized person’s name, and the requested record information. Sign and date it before a notary; the authorized individual must also provide valid identification.
- Do I need to sign this form in front of a notary?
- Yes. The form states that the authorizing person must sign and date the statement in the presence of a notary public.
- Can I sign this form with an online notary?
- New Jersey permanently authorized remote online notarization and remote ink notarization for its own notaries in October 2021. You can book a commissioned online notary; confirm with the municipality if unsure.
- What identification does the authorized person need?
- The form says the authorized individual must provide valid identification. It does not specify which identification documents are accepted.
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