Plattsburgh, NY · Clinton County

No notary required

Application for Copy of Birth Record Certificate

This application lets a person request a copy of a birth record from the local registrar and provide the information and identification required.

What this form is

Use this application to request a copy of a birth record from the local registrar. It asks for the person’s name, date and place of birth, parent information, number of copies, purpose, applicant’s relationship, contact details, and signature. The form lists acceptable identification and says a copy should not be issued unless one listed type is presented.

Who needs it

A person requesting a birth record copy should complete this application and present one of the listed types of acceptable identification.

How to submit it

Submit the application to the local registrar. The form does not provide an address, email, portal, or fee information.

About notarization

This document is signed without a notary; the applicant signs and dates the application, and no notarized or sworn attachment is mentioned.

How to submit this form

  1. 1

    Download The Application

    Download the birth record copy application.

  2. 2

    Complete The Application

    Enter the requested birth, parent, purpose, relationship, and applicant contact information.

  3. 3

    Gather Identification

    Prepare one type of identification listed on the form; it says a copy should not be issued unless acceptable identification is presented.

  4. 4

    Submit To The Local Registrar

    Submit the completed application to the local registrar. The form does not give submission contact details.

Frequently asked questions

Do I need a notary for the birth record copy application?
No. This application is signed without a notary; the applicant signs and dates it. No notarized or sworn attachment is mentioned.
How do I submit the birth record copy application?
Submit the application to the local registrar. The form does not provide an address, email, portal, or fee information.
What information does the application ask for?
It asks for birth and parent information, the number of copies requested, the purpose, the applicant’s relationship to the person, contact details, and the applicant’s signature.
What identification should I provide?
The form lists acceptable identification, including a driver’s license, passport, military ID, employer photo ID, two utility bills showing your name and address, or a police report of lost or stolen ID.

Need something notarized?

This Application for Copy of Birth Record Certificate doesn’t need a notary — but if you have another Plattsburgh form that does, a commissioned online notary can help.