What does this death record application request?

It requests a death record copy or a no-record certification. The application asks for information about the deceased and applicant, the purpose of the request, and the number of copies.

Do I need a notary for the death record application?

No. This application has an applicant signature line but no notary block or sworn attachment; the signer just signs and dates it.

How do I submit the death record application?

Return it to the Village of Saranac Lake Registrar at 39 Main Street, Suite 9, Saranac Lake, NY 12983. Include a check or money order; the form says not to send cash or stamps.

Harrietstown, NY · Franklin County

No notary required

Application to Local Registrar for Copy of Death Record

This application lets a person request a copy of a death record or a no-record certification from the Village of Saranac Lake Registrar.

What this form is

Use this application to request copies of a death record or a no-record certification from the Village of Saranac Lake Registrar. It asks for details about the deceased, including name, date of death, Social Security number, parents’ names, and place of death, along with the applicant’s relationship, purpose, contact information, signature, and number of copies requested. The form lists a fee of $10 per copy or certification.

Who needs it

Anyone requesting a death record copy or no-record certification from the Village of Saranac Lake Registrar can use this application.

How to submit it

Return the application to the Village of Saranac Lake Registrar, 39 Main Street, Suite 9, Saranac Lake, NY 12983. The form lists a $10 fee per copy or certification and says to pay by check or money order, not cash or stamps.

About notarization

This application is signed and dated by the applicant without a notary; it lists no notarized or sworn attachment, so the signer just signs and dates it.

How to submit this form

1
Download The Application
Download the death record copy application.
2
Complete The Form
Print or type the deceased’s details, applicant information, purpose, and requested number of copies.
3
Prepare The Payment
Include a check or money order for the listed fee; do not send cash or stamps.
4
Return The Application
Send it to the Village of Saranac Lake Registrar at the address printed on the form.

Frequently asked questions

What does this death record application request?: It requests a death record copy or a no-record certification. The application asks for information about the deceased and applicant, the purpose of the request, and the number of copies.
Do I need a notary for the death record application?: No. This application has an applicant signature line but no notary block or sworn attachment; the signer just signs and dates it.
How do I submit the death record application?: Return it to the Village of Saranac Lake Registrar at 39 Main Street, Suite 9, Saranac Lake, NY 12983. Include a check or money order; the form says not to send cash or stamps.

Need something notarized?

This Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another Harrietstown form that does, a commissioned online notary can help.