Do I need a notary for the Application for Death Record?

No. The application itself is signed without a notary. The form does require a notarized letter authorizing release of the certificate when that identification option applies.

How do I submit the death record application?

Mail the application to the Town of Keene, PO Box 245, Keene, NY. Include a check payable to Town of Keene and a self-addressed stamped envelope.

What information does the application ask for?

It asks for details about the deceased, the requester’s name and contact information, relationship to the person, purpose of the request, and number of copies.

What is the fee for a certified copy?

The form lists a $10 fee for each certified copy and says checks should be made payable to Town of Keene.

Keene, NY · Essex County

No notary required

Application for Death Record

This application is for people requesting a death record from the Town of Keene and asks for details about the deceased and the requester.

What this form is

Use this application to request a death record from the Town of Keene. It asks for the deceased person’s identifying details, the requester’s contact information and relationship, the reason for the request, and the number of copies. The form lists identification requirements, a $10 fee for each certified copy, and a request to enclose a self-addressed stamped envelope.

Who needs it

Anyone requesting a death record from the Town of Keene should complete the application and provide the identification listed on the form.

How to submit it

Mail the application to the Town of Keene, PO Box 245, Keene, NY, with payment by check payable to Town of Keene and a self-addressed stamped envelope. The form lists [email protected] and 518-576-4444.

About notarization

This application is signed without a notary; the form requires a notarized authorization letter when that identification option applies.

How to submit this form

1
Download The Application
Download the Town of Keene Application for Death Record.
2
Complete The Form
Print clearly and provide the deceased person’s details, your contact information, relationship, purpose, and requested number of copies.
3
Gather Identification
Provide the identification listed on the form; if using the authorization option, include a notarized letter authorizing release.
4
Mail The Application
Send it to Town of Keene, PO Box 245, Keene, NY, with the listed fee by check and a self-addressed stamped envelope.

Frequently asked questions

Do I need a notary for the Application for Death Record?: No. The application itself is signed without a notary. The form does require a notarized letter authorizing release of the certificate when that identification option applies.
How do I submit the death record application?: Mail the application to the Town of Keene, PO Box 245, Keene, NY. Include a check payable to Town of Keene and a self-addressed stamped envelope.
What information does the application ask for?: It asks for details about the deceased, the requester’s name and contact information, relationship to the person, purpose of the request, and number of copies.
What is the fee for a certified copy?: The form lists a $10 fee for each certified copy and says checks should be made payable to Town of Keene.

Need something notarized?

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