Do I need a notary for the birth record copy application?

No. The form has a signature and date field but no notary block or notarized attachment; the applicant signs and dates it.

What information does the application ask for?

It asks for birth details, parents’ names, the number of copies requested, the purpose, the applicant’s relationship to the person, and the applicant’s contact information and signature.

What identification does the form list?

It lists a driver’s or 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.

Moira, NY · Franklin County

No notary required

Application to Local Registrar for Copy of Birth Record

This application lets a person request a copy of a birth record from the local registrar and state the reason for the request.

What this form is

Use this New York State Department of Health application to request a copy of a birth record from the local registrar. It asks for the person’s name, date and place of birth, parents’ names, number of copies, purpose, applicant’s relationship to the person, contact details, signature, and address. The form lists acceptable identification and says not to issue a copy unless one listed type is presented.

Who needs it

A person requesting a birth record copy for themselves or someone else can use this application and must state their relationship to that person.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This application is signed and dated without a notary; it does not identify any notarized or sworn attachment.

How to submit this form

1
Download The Application
Download the birth record copy application PDF.
2
Complete The Application
Enter the birth details, requested number of copies, purpose, relationship, contact information, and applicant address.
3
Gather Identification
Present one of the identification types listed on the form; it says not to issue a copy unless listed identification is presented.
4
Submit To The City
Submit the application to the city department named on the form; check the city website for current contact details.

Frequently asked questions

Do I need a notary for the birth record copy application?: No. The form has a signature and date field but no notary block or notarized attachment; the applicant signs and dates it.
How do I submit the birth record copy application?: The document does not provide submission instructions. Submit it to the city department named on the form and check the city website for current contact details.
What information does the application ask for?: It asks for birth details, parents’ names, the number of copies requested, the purpose, the applicant’s relationship to the person, and the applicant’s contact information and signature.
What identification does the form list?: It lists a driver’s or 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 Moira form that does, a commissioned online notary can help.