Burke, NY · Franklin County
Application to Local Registrar for Copy of Death Record
This application lets a person request a copy of a death record from the local registrar by providing details about the deceased and the applicant.
At a glance
- Issued by
- City of Burke · Burke, Franklin County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- burkeny.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request a copy of a death record or a no-record certification from the local registrar. It asks for the deceased person's identifying details, date or period to search, place of death, and the applicant's relationship and contact information. It also asks the applicant to state the purpose of the request and how many copies are wanted, including whether they should show confidential cause of death.
Who needs it
A person requesting a death record copy or no-record certification from the local registrar needs to complete this application.
How to submit it
Submit the application to the local registrar. The form lists a $10 fee per copy or no-record certification and says not to send cash or stamps.
About notarization
This application is signed and dated without a notary; the form does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download the Application
Download the death record copy application PDF.
- 2
Complete the Application
Provide the requested details about the deceased, your relationship and contact information, and the number of copies requested.
- 3
Prepare the Fee
The form lists a $10 fee per copy or no-record certification. Do not send cash or stamps.
- 4
Submit to the Local Registrar
Submit the completed application to the local registrar.
Frequently asked questions
- Do I need a notary for the death record copy application?
- No. The application is signed and dated without a notary, and the form does not identify an attachment or related step that must be notarized or sworn.
- How do I submit the death record copy application?
- Submit the completed application to the local registrar. The form lists a $10 fee per copy or no-record certification and says not to send cash or stamps.
- What information does the application ask for?
- It asks for details about the deceased, the date or period to search, place of death, purpose of the request, and the applicant's relationship and contact information.