Do I need a notary for the New York State Death Record Application?

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

How do I submit the death record application?

The form is addressed to a local registrar but gives no submission address. Submit it to the city department named on the form; check the city website for current contact details.

What does the application request?

It asks for information about the deceased, the applicant, the purpose of the request, and the address where the record should be sent.

What fee does the application list?

The form lists a fee of $10 per copy or no-record certification and says not to send cash or stamps.

New Bremen, NY · Lewis County

No notary required

New York State Death Record Application

This application lets a person request a copy of a New York State death record or a no-record certification from a local registrar.

What this form is

Use this application to request a copy of a death record or a no-record certification. It asks for details about the deceased, the applicant’s relationship and capacity, the purpose of the request, and where to send the record. The form lists a $10 fee per copy and says not to send cash or stamps.

Who needs it

Anyone requesting a copy of a death record or a no-record certification can use this application to provide the requested information.

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 document is signed and dated without a notary; it lists no notarized or sworn attachment, so the applicant just signs and dates it.

How to submit this form

1
Download The Application
Download the New York State death record application PDF.
2
Complete The Application
Print or type the deceased’s details, your information, the purpose of the request, and the mailing address for the record.
3
Gather Any Attachments
The form lists no attachments.
4
Submit The Application
Submit it 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 New York State Death Record Application?: No. The application has a signature and date line but no notary block or notarized attachment; the applicant just signs and dates it.
How do I submit the death record application?: The form is addressed to a local registrar but gives no submission address. Submit it to the city department named on the form; check the city website for current contact details.
What does the application request?: It asks for information about the deceased, the applicant, the purpose of the request, and the address where the record should be sent.
What fee does the application list?: The form lists a fee of $10 per copy or no-record certification and says not to send cash or stamps.

Need something notarized?

This New York State Death Record Application doesn’t need a notary — but if you have another New Bremen form that does, a commissioned online notary can help.