Minerva, NY · Essex County
Application to Local Registrar for Copy of Birth Record
This application lets a person request a copy of a birth record from a local registrar by providing birth details, applicant information, and the reason for the request.
At a glance
- Issued by
- City of Minerva · Minerva, Essex County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- townofminerva.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This New York State Department of Health application lets an applicant request a copy of a birth record from a local registrar. It asks for the person's birth details, the applicant's relationship and contact information, the number of copies, and the reason for the request; attach a photocopy of acceptable identification, which the form says is required before a copy is issued.
Who needs it
A person requesting a birth record copy from a local registrar can use this application and provide the requested applicant and birth information.
How to submit it
Submit the completed application to the local registrar; attach a photocopy of an acceptable ID, which the form says must be presented.
About notarization
This application is signed and dated without a notary; attach a photocopy of acceptable identification, and the form states no notarized attachment is needed.
How to submit this form
- 1
Download the Application
Download the application for a copy of a birth record from a local registrar.
- 2
Complete the Application
Fill in the birth information, applicant details, number of copies, and purpose for the request.
- 3
Gather Identification
Make a photocopy of one of the acceptable identification types listed on the form and attach it.
- 4
Submit to the Local Registrar
Submit the completed application and ID photocopy to the local registrar.
Frequently asked questions
- Do I need a notary for the birth record copy application?
- No. The application has a signature and date line but no notary block. Attach a photocopy of acceptable identification; the form does not state that the attachment must be notarized.
- How do I submit the birth record copy application?
- Submit the completed application to the local registrar and attach a photocopy of an acceptable ID. The form says an acceptable type of identification must be presented before a copy is issued.
- What information does the application ask for?
- It asks for birth details, the number of copies requested, the reason for the request, and the applicant's name, relationship, telephone number, Social Security number, address, signature, and date.
- What identification does the form list as acceptable?
- The form lists a driver's license, non-driver's license, passport, naturalization papers, military ID, employer photo ID, two utility bills showing the applicant's name and address, or a police report of lost or stolen ID.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary, but if you have another Minerva form that does, a commissioned online notary can help.