Clarendon, NY · Orleans County
Application for Copy of Birth Record
This application requests a copy of a birth record from a 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 a local registrar. It asks for the person's name, date and place of birth, parents' names, the number of copies requested, and the purpose of the request. The applicant also provides their relationship to the person, contact details, signature, and address.
Who needs it
A person seeking a copy of a birth record completes this application and states their relationship to the person named in the record.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed and dated without a notary; it lists no notarized attachment or related sworn step.
How to submit this form
- 1
Download The Application
Download the application for a copy of a birth record.
- 2
Complete The Form
Enter the requested birth details, purpose, relationship to the person, applicant information, and signature.
- 3
Check For Attachments
The form lists no attachments; review it for any additional information requested.
- 4
Submit The Application
Submit it 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 copy application?
- No. This application is signed and dated without a notary, and it lists no notarized attachment or related sworn step.
- How do I submit the birth record copy application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the birth record application ask for?
- It asks for the person's name, date and place of birth, parents' names, number of copies, purpose, applicant's relationship, contact details, signature, and address.