Lima, NY · Livingston County
Application for Correction of Certificate of Death
This application lets an eligible person request a correction or addition to a death certificate and submit supporting evidence when required.
What this form is
Use this form to correct information entered in error or add information omitted when the original death certificate was filed. The instructions say it should be completed by the physician who signed the original certificate or the person who supplied its information; other changes require a court order. It asks for the deceased’s identifying details, the requested correction, the reason, the applicant’s relationship, and documentary evidence when required.
Who needs it
The physician who signed the original death certificate or the person who supplied its information should complete and sign this application.
How to submit it
Return the form to the Correction Unit or Registrar of Vital Statistics for your local area. The instructions also list Vital Records Section, P.O. Box 2602, Albany, NY 12220-2602.
About notarization
This document is signed without a notary; the applicant affirms the statements under penalties of perjury and submits documentary evidence when required.
How to submit this form
- 1
Download the Application
Download the Application for Correction of Certificate of Death.
- 2
Complete the Form
Enter the death certificate details, requested correction, reason for the error or omission, and your relationship to the deceased.
- 3
Gather Supporting Evidence
Include documentary evidence for corrections that require it; the instructions identify changes for which evidence is not required.
- 4
Sign and Submit
Sign and date the application, then return it to the Correction Unit or Registrar of Vital Statistics for your local area.
Frequently asked questions
- What does the Application for Correction of Certificate of Death do?
- It requests correction of information entered in error or addition of information omitted when the original death certificate was filed.
- Who should complete this application?
- The instructions say it should be completed and signed by the physician who signed the original death certificate or the person who furnished information for it.
- Do I need a notary for the Application for Correction of Certificate of Death?
- No. The applicant signs without a notary and affirms the statements under penalties of perjury. Documentary evidence must accompany the application when required.
- How do I submit the Application for Correction of Certificate of Death?
- Return it to the Correction Unit or Registrar of Vital Statistics for your local area. The instructions also provide a Vital Records Section mailing address in Albany.
Need something notarized?
This Application for Correction of Certificate of Death doesn’t need a notary — but if you have another Lima form that does, a commissioned online notary can help.