Philadelphia, NY · Jefferson County
Application for Copy of Death Record
This application lets a person request a copy of a death record from a local registrar and provide identification and details about the deceased.
What this form is
Use this application to request copies of a death record from a local registrar. It asks for the deceased person’s identifying details, date or search period, place of death, number of copies, and the purpose of the request. Applicants must include copies of identification: either one listed photo ID or two listed documents showing their name and address.
Who needs it
Anyone requesting a copy of a death record from a local registrar must complete the application and provide the required identification copies.
How to submit it
Submit the application to the local registrar with copies of the required identification. The form does not provide an address or other contact details.
About notarization
This application is signed without a notary; it requires copies of identification as supporting documents, and the applicant signs the form.
How to submit this form
- 1
Download The Application
Download the application for a copy of a death record.
- 2
Complete The Application
Enter the deceased person’s details, request information, purpose, relationship, and your contact information.
- 3
Gather Identification Copies
Include copies of one listed valid photo ID or two listed documents showing your name and address.
- 4
Submit To The Local Registrar
Submit the completed application and identification copies to the local registrar.
Frequently asked questions
- What information does the death record application request?
- It asks for details about the deceased, the requested number of copies, the purpose of the request, the applicant’s relationship, and the applicant’s contact information.
- What identification must I include?
- Include copies of either one listed valid photo ID or two listed documents showing your name and address.
- Do I need a notary for the death record application?
- No. The application is signed without a notary. It requires copies of identification, and the applicant signs the form.
- How do I submit the death record application?
- Submit the application to the local registrar with copies of the required identification. The form does not provide an address or other contact details.