Chazy, NY · Clinton County
Application to Local Registrar for Copy of Death Record
This application lets eligible people request a copy of a deceased person’s death record from the local registrar and provide identification.
What this form is
Use this application to request copies of a death record from the local registrar. It asks for information about the deceased, the applicant’s relationship and purpose, the place and date of death, and the number and type of copies requested. Applicants must include copies of specified photo identification or two documents showing their name and address; people outside the listed family relationships must also provide documentation of a lawful right or claim.
Who needs it
Anyone requesting a death record copy from the local registrar should complete this application and provide the required identification and any applicable proof of a lawful right or claim.
How to submit it
Submit the application to the local registrar with copies of the required identification. The form lists fees of $30 for Monroe County and $10 per certified copy or No Record Certification for other districts.
About notarization
This application is signed and dated without a notary; include the required identification copies and, if applicable, documentation of a lawful right or claim.
How to submit this form
- 1
Download The Application
Download the death record copy application.
- 2
Complete The Form
Enter the deceased person’s details, your relationship and purpose, the requested record details, and your applicant information.
- 3
Gather Required Documents
Include copies of one listed valid photo ID or two listed documents showing your name and address; add proof of a lawful right or claim if applicable.
- 4
Sign And Date
Sign and date the application.
- 5
Submit To The Local Registrar
Submit the application and identification copies to the local registrar.
Frequently asked questions
- Do I need a notary for the death record copy application?
- No. The application has a signature and date field but no notary block. Include the required identification copies and, if applicable, documentation of a lawful right or claim.
- How do I submit the death record copy application?
- Submit the application to the local registrar with copies of the required identification. The form lists fees of $30 for Monroe County and $10 per certified copy or No Record Certification for other districts.
- What identification must I include?
- Include a copy of one listed valid photo ID, or copies of two listed documents showing your name and address. The form lists a driver license, non-driver photo-ID card, passport, or employment ID as photo-ID options.
- Who must provide proof of a lawful right or claim?
- Applicants who are not the deceased person’s parent, child, or spouse at the time of death must submit documentation of a lawful right or claim.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another Chazy form that does, a commissioned online notary can help.