Malone, NY · Franklin County
Death Record Correction Form
This application lets an eligible person request a correction to a death certificate and submit supporting evidence when required.
What this form is
Use this form to correct information entered in error or add information omitted when the original death certificate was filed. The form says it should be completed and signed by the physician who signed the original certificate or the person who provided its information. It asks for the deceased’s record details, the requested change, supporting evidence when required, the reason for the correction, and the applicant’s signature and relationship.
Who needs it
The physician who signed the original death certificate or the person who provided information for it should complete and sign the form.
How to submit it
Return the form to the Correction Unit or the Registrar of Vital Statistics for your local area. The form also lists the Vital Records Section, P.O. Box 2602, Albany, NY 12220-2602.
About notarization
This form is signed without a notary; the applicant affirms the statements under penalties of perjury, and required documentary evidence must accompany the application.
How to submit this form
- 1
Download the Form
Download the Death Record Correction Form and read the instructions on its reverse side.
- 2
Complete the Application
Provide the deceased’s record details, describe the correction, explain the reason, and enter your relationship to the deceased.
- 3
Gather Supporting Evidence
Include documentary evidence for corrections that require it; the instructions identify examples of accepted records.
- 4
Sign and Submit
Sign and date the application, then return it to the local Registrar of Vital Statistics or the listed Vital Records Section address.
Frequently asked questions
- Do I need a notary for the Death Record Correction Form?
- No. The form has no notary block; the applicant signs and affirms the statements under penalties of perjury. Include documentary evidence when required.
- Who should complete and sign the form?
- The instructions say the form should be completed and signed by the physician who signed the original death certificate or the person who furnished information for it.
- What supporting documents are required?
- Documentary evidence is required for corrections other than the listed exceptions, such as adding previously unavailable information, minor spelling changes, or a birth-date change of one year or less.
- How do I submit the Death Record Correction Form?
- Return it to the Correction Unit or the Registrar of Vital Statistics for your local area. The form also lists the Vital Records Section in Albany as a return address.