Goshen, NY · Orange County
Third Party Pick Up for Birth Certificates
This application lets someone authorize a third party to pick up their birth certificate from the Village of Goshen.
What this form is
Use this application when you cannot come to the Village office yourself and need a third party to pick up your birth certificate. The applicant completes, prints, and signs the application and provides copies of identification. The third party brings the application, provides proof of identity, and co-signs it; the applicant also provides a signed, dated, notarized permission letter.
Who needs it
A person who cannot pick up their birth certificate in person and wants to authorize someone else to collect it needs this application.
How to submit it
Send the completed, signed application with the third party picking up the record. The form lists the Village of Goshen at 276 Main Street, Goshen, NY 10924, but does not specify a submission process.
About notarization
The application is signed without a notary; a separate permission letter must be signed, dated, and notarized to authorize the third party.
How to submit this form
- 1
Download The Application
Download the Third Party Pick Up for Birth Certificates application.
- 2
Complete And Sign
Complete, print, and sign the application form.
- 3
Gather Identification And Letter
Include copies of your identification and provide a signed, dated, notarized letter authorizing the named person to pick up the record.
- 4
Send With The Third Party
Send the completed, signed application with the person picking up the record; that person must provide proof of identity and co-sign the application.
Frequently asked questions
- Do I need a notary for the Third Party Pick Up for Birth Certificates application?
- No. The application itself is signed without a notary, but the separate permission letter authorizing the third party must be signed, dated, and notarized.
- How do I submit the birth certificate pickup application?
- Send the completed, signed application with the person picking up the record. The form lists the Village at 276 Main Street, Goshen, NY 10924, but does not specify a submission process.
- What does the third party need to provide?
- The person picking up the record must provide proof of identity using the same criteria referenced on the form and co-sign the application.
- What must the permission letter say?
- The signed, dated, notarized letter must identify who will pick up the record, which record they will pick up, and state that you give them permission.
Need something notarized?
This Third Party Pick Up for Birth Certificates doesn’t need a notary — but if you have another Goshen form that does, a commissioned online notary can help.