Virgil, NY · Cortland County
Mail-In Application for Copy of Death Certificate
This New York State form requests a copy of a death certificate; applicants complete it, provide required identification, and mail it with payment to the Vital Records Section.
- 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 application to request a copy of a death certificate from the New York State Department of Health Vital Records Section. It asks for information about the deceased, the applicant’s relationship and purpose, and the requested delivery address. The form says to include required identification and payment; applicants seeking delivery to a P.O. box or third party must also submit a notarized statement signed by the applicant and a copy of the applicant’s driver license.
Who needs it
People requesting a death-certificate copy by mail use this form, and applicants requesting delivery to a P.O. box or third party must provide additional notarized documentation.
Why it needs a notary
The application has no notary block; for delivery to a P.O. box or third party, the applicant signs a separate notarized statement.
How to get this notarized
- 1
Download the Application
Get the Mail-In Application for Copy of Death Certificate.
- 2
Complete the Form
Enter the deceased’s details, your relationship and purpose, and the applicant and delivery addresses.
- 3
Book an Online Notary
If delivery is to a P.O. box or third party, arrange notarization for your separate signed statement.
- 4
Sign on Video
Sign the additional statement during your online notary session.
- 5
Mail Your Request
Include the application, required identification, payment, and any required statement and driver license copy; mail them to the Vital Records Section.
Preview the form
The blank PDF straight from Virgil. 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 request a death certificate copy by mail?
- Complete the application, include required identification and a check or money order, then mail it to the New York State Department of Health Vital Records Section.
- Do I need a notarized statement with this application?
- The form requires a notarized statement signed by the applicant when the requested delivery address is a P.O. box or a third party. It also requires a copy of the applicant’s driver license.
- Can I sign the additional statement with an online notary?
- New York authorizes its notaries to perform remote online notarization under Executive Law §135-c. Check with the Vital Records Section about acceptance of an online-notarized statement; confirm with the city, town or village if unsure.
- What information should I gather before filling it out?
- The form asks for details about the deceased, the applicant’s relationship and purpose, the applicant’s contact information, and the mailing and delivery addresses. Include required identification and payment.