What information does the death record application request?

It asks for details about the deceased, including name, date of death or search period, and other identifying information, as well as the applicant’s relationship, purpose, signature, and address.

How do I submit the death record application?

Complete the form and enclose the listed fee. It says not to send cash or stamps and is addressed to the Local Registrar in Albany, NY 12937-0023.

Do I need a notary for the death record application?

No. The application is signed and dated without a notary, and it does not identify any notarized attachment or sworn step.

Russell, NY · St. Lawrence County

No notary required

Application for Copy of Death Record

This application lets a person request a copy of a death record from the local registrar by providing details about the deceased and the request.

What this form is

Use this application to request a copy of a death record or a no-record certification from the local registrar. It asks for information about the deceased, the applicant’s relationship and capacity, the purpose of the request, and the applicant’s signature and address. The form lists a $10 fee per copy or no-record certification.

Who needs it

Anyone requesting a copy of a death record or a no-record certification can use this application to provide the requested details.

How to submit it

Complete the form and enclose the $10 fee per copy or no-record certification; do not send cash or stamps. The form is addressed to the Local Registrar in Albany, NY 12937-0023.

About notarization

This application is signed and dated without a notary; the form does not identify any notarized attachment or sworn step.

How to submit this form

1
Download The Application
Download the application for a copy of a death record.
2
Complete The Form
Print or type the requested information about the deceased, your relationship and capacity, and the purpose of the request.
3
Gather The Fee
Enclose $10 per copy or no-record certification. Do not send cash or stamps.
4
Submit To The Registrar
Send the completed form and fee to the Local Registrar at the address printed on the application.

Frequently asked questions

What information does the death record application request?: It asks for details about the deceased, including name, date of death or search period, and other identifying information, as well as the applicant’s relationship, purpose, signature, and address.
How do I submit the death record application?: Complete the form and enclose the listed fee. It says not to send cash or stamps and is addressed to the Local Registrar in Albany, NY 12937-0023.
Do I need a notary for the death record application?: No. The application is signed and dated without a notary, and it does not identify any notarized attachment or sworn step.

Need something notarized?

This Application for Copy of Death Record doesn’t need a notary — but if you have another Russell form that does, a commissioned online notary can help.