Piercefield, NY · St. Lawrence County
Application for Birth Record
This application lets a person request a certified birth record or No Record Certification from the Local Registrar.
What this form is
Use this application to request a copy of a birth record or a No Record Certification. It asks for the person’s name and birth details, the applicant’s information and relationship, the reason for the request, and the number of copies. The form lists fees and requires copies of identification; applicants other than the child or parents named on the record need notarized authorization.
Who needs it
Anyone requesting a birth record or No Record Certification from the Local Registrar should complete this application and provide the required identification copies.
How to submit it
The form is an application to the Local Registrar, but gives no mailing address or submission channel. Submit it to the city department named on the form; check the city website for current contact details.
About notarization
The application is signed without a notary; if the requester is not the child or a parent named on the record, notarized authorization is required.
How to submit this form
- 1
Download The Application
Download the birth record application PDF.
- 2
Complete The Application
Enter the requested birth, applicant, relationship, purpose, and copy information, then sign and date the form.
- 3
Gather Identification
Attach copies of one acceptable photo ID or two documents showing your name and address.
- 4
Submit To The City
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 application itself is signed without a notary. If you are not the child or a parent named on the requested record, notarized authorization is required.
- How do I submit the birth record application?
- The form identifies the Local Registrar but gives no mailing address or submission channel. Submit it to the city department named on the form; check the city website for current contact details.
- What identification must I provide?
- Submit copies of either one valid photo ID listed on the form or two listed documents showing your name and address. A passport copy is required for requests from a foreign country that requires a U.S. Passport for travel.
- What does the application ask for?
- It asks for the birth record subject’s name and birth details, the applicant’s information and relationship, the purpose of the request, and the number of copies.
Need something notarized?
This Application for Birth Record doesn’t need a notary — but if you have another Piercefield form that does, a commissioned online notary can help.