Holland, NY · Erie County
Application to Local Registrar for Copy of Death Record
This application is for a person requesting a copy of a death record from the local registrar and asks for details about the deceased and applicant.
What this form is
Use this application to request a copy of a death record from the local registrar. It asks for identifying information about the deceased, the period to be covered by the search, the purpose of the request, the applicant’s relationship and capacity, and the number of copies requested with or without confidential cause of death. The form does not state when the city requires it.
Who needs it
A person seeking a copy of a death record from the local registrar can use this application to provide the requested information.
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 has no notary block; the applicant signs it, and the form lists no sworn or notarized attachment.
How to submit this form
- 1
Download The Application
Download the Application to Local Registrar for Copy of Death Record.
- 2
Complete The Application
Enter the requested details about the deceased, search period, purpose, your relationship and capacity, contact information, and copies requested.
- 3
Check For Attachments
The form lists no attachments; check with the local registrar if you are unsure whether anything else is needed.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the death record copy application?
- No. This application has no notary block; the applicant signs it, and the form lists no sworn or notarized attachment.
- How do I submit the death record copy application?
- Submit it to the city department named on the form; check the city website for current contact details. The form itself does not provide submission instructions.
- What information does the application ask for?
- It asks for details about the deceased, the search period, the purpose of the request, your relationship and capacity, applicant contact information, and the number of copies requested.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another Holland form that does, a commissioned online notary can help.