Fleischmanns, NY · Delaware County
Birth Certificate Request
This application lets a person request a copy of a birth record from the local registrar by providing record details, applicant information, and identification.
What this form is
Use this New York State Department of Health application to request copies of a birth record from a local registrar. It asks for the subject’s name, birth date and place, number of copies requested, the applicant’s purpose and relationship, contact details, address, signature, and date. The registrar section records identification information; an acceptable form of ID must be presented, with a photocopy attached.
Who needs it
A person requesting a copy of a birth record from the local registrar completes this application and provides acceptable 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 application is signed and dated without a notary; attach a photocopy of acceptable identification and present one of the listed ID types.
How to submit this form
- 1
Download The Application
Download the Birth Certificate Request application.
- 2
Complete The Application
Enter the birth record details, requested number of copies, applicant information, purpose, signature, and date.
- 3
Gather Identification
Present one of the identification types listed on the form and attach a photocopy.
- 4
Submit To The Local Registrar
Submit the application to the local registrar; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for a Birth Certificate Request?
- No. Sign and date the application without a notary. Attach a photocopy of acceptable identification and present one of the listed ID types.
- How do I submit the Birth Certificate Request?
- The application is for the local registrar, but it does not provide submission contact details. Check the city website for current contact information.
- What information does the application ask for?
- It asks for birth record details, the number of copies requested, the applicant’s purpose and relationship to the person, contact information, address, signature, and date.
- What identification must I provide?
- The form says not to issue a copy unless an acceptable type of identification is presented. It also directs the applicant to attach a photocopy of ID.
Need something notarized?
This Birth Certificate Request doesn’t need a notary — but if you have another Fleischmanns form that does, a commissioned online notary can help.