Walden, NY · Orange County
Application for Copy of Birth Record
This application requests a copy of a birth record from the local registrar and is completed by the person seeking the record.
What this form is
Use this New York State Department of Health application to request a copy of a birth record from the local registrar. It asks for the person’s birth details, the applicant’s relationship and contact information, the number of copies requested, and the reason for the request. Applicants must include copies of qualifying identification; a notarized authorization is required if the applicant is not the child or a parent named on the certificate.
Who needs it
Anyone requesting a copy of a birth record from the local registrar should complete this application and provide the required identification.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
The applicant signs and dates this form without a notary; if the requester is not the child or a parent named on the certificate, notarized authorization is required.
How to submit this form
- 1
Download The Application
Download the Application for Copy of Birth Record.
- 2
Complete The Form
Enter the requested birth, applicant, relationship, purpose, and copy-request information.
- 3
Gather Identification
Attach copies of one qualifying photo ID or two listed documents showing your name and address.
- 4
Submit To The Local Registrar
Submit the application to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the birth record application?
- No. The applicant signs and dates the application without a notary. If the requester is not the child or a parent named on the certificate, notarized authorization is required.
- How do I submit the birth record application?
- Submit it to the city department named on the form; check the city website for current contact details. Include copies of the required identification.
- What identification must I include?
- Include a copy of one listed form of valid photo identification, or copies of two listed documents showing your name and address. The form lists examples of each.
- What information does the application request?
- It asks for the recorded person's name and birth details, the applicant's relationship and contact information, the number of copies requested, and the reason for the request.
Need something notarized?
This Application for Copy of Birth Record doesn’t need a notary — but if you have another Walden form that does, a commissioned online notary can help.