Dunkirk, NY · Chautauqua County
Birth Certificate Copy Application
This application requests a copy of a birth record from a local registrar and is completed by the person requesting the record.
What this form is
Use this New York State Department of Health application to request a copy of a birth record from a local registrar. It asks for the person’s name, date and place of birth, parents’ names, number of copies, and the purpose for the request. The applicant provides their relationship to the person, contact and address details, and signature; acceptable identification must be presented.
Who needs it
A person requesting a birth record copy from a local registrar should complete this application and present an accepted form of identification.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the form lists identification to present, and the signer just signs and dates it.
How to submit this form
- 1
Download The Application
Download the Birth Certificate Copy Application PDF.
- 2
Complete The Form
Enter the requested birth, parent, applicant, contact, address, and purpose information.
- 3
Gather Identification
Prepare one of the identification types listed on the form; the form says identification must be presented.
- 4
Submit To The City
Submit the application to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Birth Certificate Copy Application?
- No. This document is signed without a notary. It lists identification to present, and the signer just signs and dates the application.
- How do I submit the Birth Certificate Copy Application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application ask for?
- It asks for the person’s name, date and place of birth, parents’ names, number of copies, request purpose, applicant relationship, contact details, address, and signature.
- What identification must I present?
- The form lists a driver’s license, non-driver’s license, passport, naturalization papers, military ID, employer photo ID, two utility bills showing your name and address, or a police report of lost or stolen ID.