Pitcairn, NY · St. Lawrence County
Application for Copy of Birth Record
This application lets a person request a copy of a birth record from the local registrar by providing birth details, applicant information, 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, date and place of birth, parents' names, number of copies requested, purpose, applicant's relationship to the person, telephone number, address, and signature. It does not state a fee or provide submission contact details.
Who needs it
Anyone requesting a copy of a birth record from the local registrar can use this application.
How to submit it
Submit it to the local registrar; check the city website for current contact details.
About notarization
This document is signed without a notary; the applicant signs and dates the application.
How to submit this form
- 1
Download The Application
Download the Application for Copy of Birth Record.
- 2
Complete The Form
Enter the birth details, purpose for the record, applicant relationship and contact information.
- 3
Sign And Date
Sign and date the application.
- 4
Submit To The Local Registrar
Submit the application to the local registrar; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the birth record copy application?
- No. The application has a signature and date field but no notary block; the applicant signs and dates it.
- How do I submit the birth record copy application?
- Submit it to the local registrar. The application does not list submission contact details, so check the city website for current information.
- What information does the application ask for?
- It asks for birth details, parents' names, the number of copies requested, the purpose, the applicant's relationship to the person, and the applicant's contact information and signature.
Need something notarized?
This Application for Copy of Birth Record doesn’t need a notary — but if you have another Pitcairn form that does, a commissioned online notary can help.