Wilna, NY · Jefferson County
Application for a Copy of a Death Record
This application lets people request a copy of a death record from the Town of Wilna by providing details about the death and their relationship to the person.
What this form is
Use this application to request a copy of a death record from the Town of Wilna. It asks for the deceased person’s name, date and place of death, number of copies, purpose of the request, and the applicant’s relationship to the person. The form also requests the applicant’s signature, address, date, and the name and address where the record should be sent; it lists separate fees for regular and genealogy requests.
Who needs it
Anyone requesting a copy of a death record from the Town of Wilna should complete this application and provide their relationship to the person.
How to submit it
Complete the form and send it with the applicable fee to the Town of Wilna Registrar of Vital Statistics, 414 State Street, Carthage, NY 13619. Checks are payable to Town of Wilna; do not send cash.
About notarization
This application is signed without a notary; the applicant signs and dates the form, with no notarized attachment or sworn step listed.
How to submit this form
- 1
Download the Application
Download the Town of Wilna application for a copy of a death record.
- 2
Complete the Form
Provide the requested death record details, purpose, relationship, applicant information, and mailing address.
- 3
Enclose the Fee
Include the applicable fee. The form says to make checks payable to Town of Wilna and not to send cash.
- 4
Send It to the Registrar
Send the completed application and fee to the Registrar of Vital Statistics at 414 State Street, Carthage, NY 13619.
Frequently asked questions
- Do I need a notary for the Wilna death record application?
- No. The application is signed and dated without a notary, and the form lists no notarized attachment or sworn step.
- How do I submit the death record application?
- Complete the application and send it with the applicable fee to the Registrar of Vital Statistics at 414 State Street, Carthage, NY 13619. The form says to make checks payable to Town of Wilna and not to send cash.
- What information does the application ask for?
- It asks for the deceased person's name, date and place of death, number of copies, purpose of the request, your relationship to the person, and your contact and mailing information.
- What fee does the form list?
- The form lists $10.00 per copy, or $22.00 per copy for genealogy requests. It instructs applicants to enclose the fee and not send cash.
Need something notarized?
This Application for a Copy of a Death Record doesn’t need a notary — but if you have another Wilna form that does, a commissioned online notary can help.