Do I need a notary for the death record copy application?

No. The application is signed and dated without a notary, and the form does not mention a notarized or sworn attachment.

How do I submit the death record copy application?

Complete the form and enclose $10 per copy or No Record Certification, payable to the Annsville Town Clerk. The form lists the Town of Annsville address in Taberg.

What information does the application ask for?

It asks for details about the deceased, the reason for the request, your relationship and capacity, your signature and date, and your name and mailing address.

What is the fee listed on the form?

The form lists a fee of $10 per copy or No Record Certification and says not to send cash or stamps.

Annsville, NY · Oneida County

No notary required

Application to Local Registrar for Copy of Death Record

This application lets a person request a death record copy or No Record Certification from the Annsville Town Clerk.

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, including their name, date of death, parents’ names, and place of death, as well as the applicant’s relationship, purpose, signature, and mailing address. The form states a fee of $10 per copy or certification.

Who needs it

Anyone requesting a death record copy or No Record Certification from the Annsville Town Clerk should complete this application.

How to submit it

Complete the form, enclose the $10 fee per copy or No Record Certification, and make payment payable to the Annsville Town Clerk. The form lists the Town of Annsville at 4225 State Route 69, Taberg, NY 13471.

About notarization

This document is signed and dated without a notary; the form does not mention a notarized or sworn attachment.

How to submit this form

1
Download The Application
Download the death record copy application.
2
Complete The Form
Print or type the requested details about the deceased and applicant, then sign and date the application.
3
Enclose The Fee
Enclose $10 per copy or No Record Certification; make payment payable to the Annsville Town Clerk. Do not send cash or stamps.
4
Submit To The Town
Send the completed application and fee to the Town of Annsville, 4225 State Route 69, Taberg, NY 13471.

Frequently asked questions

Do I need a notary for the death record copy application?: No. The application is signed and dated without a notary, and the form does not mention a notarized or sworn attachment.
How do I submit the death record copy application?: Complete the form and enclose $10 per copy or No Record Certification, payable to the Annsville Town Clerk. The form lists the Town of Annsville address in Taberg.
What information does the application ask for?: It asks for details about the deceased, the reason for the request, your relationship and capacity, your signature and date, and your name and mailing address.
What is the fee listed on the form?: 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 Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another Annsville form that does, a commissioned online notary can help.