Mount Hope, NY · Orange County
Application to Local Registrar for Copy of Death Record
This application lets a person request a copy of a death record or a no-record certification from the Town of Mount Hope.
What this form is
Use this application to request a copy of a death record from the Town of Mount Hope, or a no-record certification if the town does not have the record. The form asks for information about the deceased, the applicant’s relationship and purpose, and the requested record details. It also asks how many copies are wanted, whether a confidential cause of death should be included, and where to mail the record.
Who needs it
Anyone requesting a copy of a death record or no-record certification from the Town of Mount Hope should complete this application.
How to submit it
Mail the completed form, a $10 money order payable to “Town of Mount Hope,” and a clear photocopy of a valid driver’s license or other valid ID to 1706 Route 211 West, Otisville, NY 10963.
About notarization
This application is signed without a notary; include the required money order and ID photocopy, with no notarized attachment stated.
How to submit this form
- 1
Download The Application
Download the death record application.
- 2
Complete The Form
Complete the form as fully as possible, including the deceased’s details, your relationship, the purpose, and where the record should be sent.
- 3
Gather Required Items
Include a $10 money order payable to “Town of Mount Hope” and a clear photocopy of valid identification.
- 4
Mail The Request
Mail the form and required items to 1706 Route 211 West, Otisville, NY 10963.
Frequently asked questions
- Do I need a notary for the death record application?
- No. The application is signed without a notary. The instructions require a $10 money order and a clear photocopy of valid identification; no notarized attachment is stated.
- How do I submit the death record application?
- Mail the completed application, a $10 money order payable to “Town of Mount Hope,” and a clear photocopy of valid ID to 1706 Route 211 West, Otisville, NY 10963.
- What identification can I include?
- The instructions list a driver’s license, non-driver’s license, or passport as acceptable identification. Send a clear photocopy of valid identification with the application.
- What if the town does not have the death record?
- The instructions say the town will send a “no record” certification if it does not have the requested record.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another Mount Hope form that does, a commissioned online notary can help.