Do I need a notary for the certified birth certificate application?

No. The application is signed and dated without a notary. If you are not the child or a parent named on the certificate, the form requires notarized authorization.

How do I submit the application?

Submit the completed application to the local registrar. Include copies of either one listed form of valid photo ID or two listed documents showing your name and address.

What information does the application request?

It asks for the name and birth details on the certificate, the number of copies, the purpose, your relationship to the person, and your address and telephone number.

What fee does the form list?

The form lists $30.00 per certified copy or No Record Certification for county districts, and $10.00 for other districts.

Nyack, NY · Rockland County

No notary required

Application for Copy of Certified Birth Certificate

This application lets a person request a certified birth record copy from the local registrar by providing details about the birth and the reason for the request.

What this form is

Use this application to request a copy of a birth record from the local registrar. It asks for the person’s name and birth details, the number of copies, the purpose of the request, the applicant’s relationship to that person, and contact information. Include copies of the required photo identification or address documents; the form lists a fee per certified copy or No Record Certification.

Who needs it

Anyone requesting a certified birth record copy should complete this application and provide the required identification documents.

How to submit it

Submit the application to the local registrar. The form lists a fee of $30.00 for county districts or $10.00 for other districts per certified copy or No Record Certification.

About notarization

This application is signed and dated without a notary; applicants other than the child or parents named on the certificate must provide notarized authorization.

How to submit this form

1
Download The Application
Download the Application for Copy of Certified Birth Certificate PDF.
2
Complete The Application
Enter the birth details, number of copies, purpose, relationship to the person, and your contact information.
3
Gather Identification
Include copies of one listed valid photo ID or two listed documents showing your name and address.
4
Submit To The Local Registrar
Submit the application and required identification copies to the local registrar.

Frequently asked questions

Do I need a notary for the certified birth certificate application?: No. The application is signed and dated without a notary. If you are not the child or a parent named on the certificate, the form requires notarized authorization.
How do I submit the application?: Submit the completed application to the local registrar. Include copies of either one listed form of valid photo ID or two listed documents showing your name and address.
What information does the application request?: It asks for the name and birth details on the certificate, the number of copies, the purpose, your relationship to the person, and your address and telephone number.
What fee does the form list?: The form lists $30.00 per certified copy or No Record Certification for county districts, and $10.00 for other districts.

Need something notarized?

This Application for Copy of Certified Birth Certificate doesn’t need a notary — but if you have another Nyack form that does, a commissioned online notary can help.