What does the Death Record Copy Application request?

It requests a copy of a death record or a No Record Certification and asks for information about the deceased, the applicant, and the copies requested.

How much does a copy cost?

The form lists a fee of $10.00 per copy or No Record Certification. It says not to send cash or stamps.

How do I submit the Death Record Copy Application?

Submit it to the local registrar. The form lists the fee and says not to send cash or stamps.

Elizabethtown, NY · Essex County

No notary required

Death Record Copy Application

This application lets a person request a copy of a deceased person’s death record from the local registrar.

What this form is

Use this application to request copies of a death record or a No Record Certification. It asks for the deceased person’s identifying and death information, the applicant’s relationship and purpose, and the number of copies requested with or without the confidential cause of death.

Who needs it

Anyone requesting a copy of a death record or No Record Certification for a deceased person should complete this application.

How to submit it

Submit it to the local registrar; the form lists a $10.00 fee per copy or No Record Certification and says not to send cash or stamps.

About notarization

This document is signed without a notary; the applicant just signs and provides an address and requested-copy details.

How to submit this form

1
Download The Application
Download the Death Record Copy Application PDF.
2
Complete The Application
Enter the deceased person’s details, your relationship and purpose, and the number of copies requested.
3
Check The Fee Instructions
The form lists $10.00 per copy or No Record Certification and says not to send cash or stamps.
4
Submit To The Local Registrar
Sign the application and submit it to the local registrar.

Frequently asked questions

What does the Death Record Copy Application request?: It requests a copy of a death record or a No Record Certification and asks for information about the deceased, the applicant, and the copies requested.
How much does a copy cost?: The form lists a fee of $10.00 per copy or No Record Certification. It says not to send cash or stamps.
Do I need a notary for the Death Record Copy Application?: No. This document is signed without a notary; the applicant just signs and provides an address and requested-copy details.
How do I submit the Death Record Copy Application?: Submit it to the local registrar. The form lists the fee and says not to send cash or stamps.

Need something notarized?

This Death Record Copy Application doesn’t need a notary — but if you have another Elizabethtown form that does, a commissioned online notary can help.