North Dansville, NY · Livingston County
Application to Local Registrar for Copy of Death Record
This application lets a person request a copy of a death record from the Town of North Dansville Local Registrar and provide applicant and deceased details.
What this form is
Use this application to request a copy of a death record from the Town of North Dansville Local Registrar. It asks for information about the deceased, including name, birth and death details, parents, and place of death, as well as the applicant’s contact information, relationship, purpose, and requested copies. The form lists a $10 fee per copy and payment options.
Who needs it
A person requesting a death record copy from the Town of North Dansville Local Registrar should complete this application.
How to submit it
Send the application to the Town Clerk, Town of North Dansville, 14 Clara Barton Street, Dansville, NY 14437. The listed fee is $10 per copy; payment may be by certified bank check or money order, or cash in person only.
About notarization
This document is signed and dated by the applicant without a notary; it does not identify any notarized or sworn attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download The Application
Download the Application to Local Registrar for Copy of Death Record.
- 2
Complete The Application
Print clearly and provide the requested details about the deceased, the applicant, the purpose, and the copies requested.
- 3
Prepare The Payment
The listed fee is $10 per copy. Pay by certified bank check or money order, or use cash in person only.
- 4
Submit To The Town Clerk
Send the application to the Town Clerk at 14 Clara Barton Street, Dansville, NY 14437.
Frequently asked questions
- Do I need a notary for the North Dansville death record application?
- No. This document is signed and dated by the applicant without a notary. It does not identify any notarized or sworn attachment.
- How do I submit the death record application?
- Send it to the Town Clerk, Town of North Dansville, 14 Clara Barton Street, Dansville, NY 14437. The form lists a $10 fee per copy, payable by certified bank check or money order, or cash in person only.
- What information does the application request?
- It asks for details about the deceased and the applicant, including the applicant’s relationship, purpose for the record, contact information, and number of copies requested.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another North Dansville form that does, a commissioned online notary can help.