Dolgeville, NY · Herkimer County
Death Certificate Application
This application lets a person request a copy of a death record or a no-record certification from the Village of Dolgeville local registrar.
What this form is
Use this application to request a copy of a death record or a no-record certification from the Village of Dolgeville. It asks for information about the deceased, the applicant’s relationship and purpose, and where to send the record. The form also requests the number of copies and whether they should include the confidential cause of death for deaths occurring as of January 1, 1988.
Who needs it
A person requesting a death record or no-record certification from the Village of Dolgeville local registrar needs to complete this application.
How to submit it
Complete the form and mail it with the $10.00 fee per copy or no-record certification to the Village of Dolgeville, 41 North Main St., Dolgeville, NY 13329. Do not send cash or stamps.
About notarization
This application is signed and dated without a notary; it lists no notarized attachment or sworn step.
How to submit this form
- 1
Download The Application
Download the Death Certificate Application PDF.
- 2
Complete The Form
Print or type the requested information about the deceased, yourself, and where the record should be sent.
- 3
Gather The Requested Details
Specify the number of copies and whether they should include the confidential cause of death, when applicable.
- 4
Submit To The Village
Mail the completed form and $10.00 fee per copy or no-record certification to the Village of Dolgeville. Do not send cash or stamps.
Frequently asked questions
- Do I need a notary for the Death Certificate Application?
- No. This application is signed and dated without a notary, and it lists no notarized attachment or sworn step.
- How do I submit the Death Certificate Application?
- Complete the form and mail it with the $10.00 fee per copy or no-record certification to the Village of Dolgeville, 41 North Main St., Dolgeville, NY 13329. Do not send cash or stamps.
- What information does the application request?
- It asks for details about the deceased, the applicant’s relationship to the deceased, the purpose of the request, and the address where the record should be sent.
- How much does a copy or no-record certification cost?
- The form states a fee of $10.00 per copy or no-record certification. It says not to send cash or stamps.