Pierrepont, NY · St. Lawrence County
Birth Record Application
This application lets a person request a copy of a birth record from a local registrar and provide details about the person whose record is requested.
What this form is
Use this 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, requested number of copies, and purpose for the request. The applicant also provides their relationship to the person, contact and address details, identification information, and a signature.
Who needs it
A person requesting a copy of a birth record completes this application with information about the record and their relationship to the person.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
No notary is required; the applicant signs and dates the application and attaches a photocopy of identification.
How to submit this form
- 1
Download The Application
Download the Birth Record Application PDF.
- 2
Complete The Application
Enter the requested birth record, applicant, purpose, contact, and address information.
- 3
Attach Identification
Attach a photocopy of identification, as directed on the application.
- 4
Sign And Submit
Sign and date the application, then submit it to the city department named on the form.
Frequently asked questions
- 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 requested, purpose, applicant relationship and contact details, identification information, and signature.
- Do I need a notary for the Birth Record Application?
- No. The applicant signs and dates the application and attaches a photocopy of identification; the document does not require a notary.
- 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.