Roxbury, NY · Delaware County
Application to Local Registrar for Copy of Birth Record
This application lets a person request a copy of a birth record from the local registrar and provide the information needed to identify the record.
What this form is
Use this application to request a copy of a birth record from the local registrar. It asks for the subject’s name, date and place of birth, parents’ names, number of copies, and the purpose of the request. Applicants also provide their relationship to the person, contact and address details, identification information, and a signature; the form directs applicants to attach a photocopy of identification.
Who needs it
A person requesting a copy of a birth record, including an attorney requesting one for a client, can use this application.
How to submit it
Submit the application to the local registrar named in the form and attach a photocopy of your identification.
About notarization
This application is signed and dated without a notary; attach a photocopy of your identification as the form directs.
How to submit this form
- 1
Download The Application
Download the birth record copy application.
- 2
Complete The Form
Enter the birth details, request purpose, applicant information, and other requested details.
- 3
Gather Identification
Attach a photocopy of your identification as directed on the form.
- 4
Submit To The Local Registrar
Sign and date the application, then submit it to the local registrar named in the form.
Frequently asked questions
- What information does the birth record application request?
- It requests birth details, parents’ names, the number of copies, the purpose of the request, the applicant’s relationship and contact details, identification information, and a signature.
- Do I need a notary for the birth record application?
- No. This application is signed and dated without a notary. Attach a photocopy of your identification as the form directs.
- How do I submit the birth record application?
- Submit the application to the local registrar named in the form and attach a photocopy of your identification.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary — but if you have another Roxbury form that does, a commissioned online notary can help.