Theresa, NY · Jefferson County
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 by providing birth details, applicant information, and identification.
At a glance
- Issued by
- City of Theresa · Theresa, Jefferson County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- townoftheresany.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request a copy of a birth record from the local registrar. It asks for the person’s birth details, the number of copies requested, the purpose for the record, and the applicant’s contact and relationship information. The applicant must sign and date the form and attach a photocopy of an accepted type of identification; the form says not to issue a copy without identification.
Who needs it
A person requesting a birth record copy from the local registrar should complete this application and provide the identification specified on the form.
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; the signer just signs and dates it, and the form requests an identification photocopy.
How to submit this form
- 1
Download the Application
Download the birth record copy application.
- 2
Complete the Application
Enter the birth and applicant information, number of copies, and purpose for the record; then sign and date the form.
- 3
Attach Identification
Photocopy and attach one type of identification listed on the form.
- 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 application asks the applicant to sign and date it without a notary. It also requests a photocopy of an accepted type of identification.
- How do I submit the birth record copy application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application ask for?
- It asks for birth details, the number of copies requested, the purpose for the record, and the applicant’s contact information and relationship to the person whose record is requested.
- What identification should I include?
- Attach a photocopy of one accepted identification type, such as a driver’s license, passport, military ID, or two utility bills showing the applicant’s name and address.