Amityville, NY · Suffolk County
Application for Birth Certificate
This application is for people requesting a birth certificate from the Village of Amityville and asks for information about the record and applicant.
What this form is
Use this application to request a birth certificate from the Village of Amityville. It asks for the person's name at birth, date and place of birth, parents' names, number of copies, and purpose for the record. Applicants provide their contact and relationship information, sign and date the form, and include a valid photo ID copy, payment by money order, and a stamped, self-addressed envelope.
Who needs it
Anyone requesting a birth certificate from the Village of Amityville should complete the application and provide the listed identification and payment.
How to submit it
Mail the application to the Village of Amityville, 21 Ireland Place, Amityville, NY 11701. Include a copy of valid photo ID, a $10-per-copy money order payable to the Village, and a stamped, self-addressed envelope; do not send a personal check.
About notarization
This application is signed without a notary; the applicant just signs and dates it.
How to submit this form
- 1
Download the Application
Download the Village of Amityville birth certificate application PDF.
- 2
Complete and Sign
Enter the birth and applicant information requested, then sign and date the application.
- 3
Gather Required Items
Include a copy of valid photo ID, a $10-per-copy money order payable to the Village, and a stamped, self-addressed envelope.
- 4
Mail to the Village
Mail the application and required items to the Village of Amityville, 21 Ireland Place, Amityville, NY 11701.
Frequently asked questions
- Do I need a notary for the Amityville birth certificate application?
- No. This application is signed without a notary; the applicant just signs and dates it.
- How do I submit the birth certificate application?
- Mail it to the Village of Amityville at 21 Ireland Place, Amityville, NY 11701. Include a valid photo ID copy, a money order, and a stamped, self-addressed envelope.
- What should I include with the application?
- Include a copy of valid photo ID, a $10-per-copy money order payable to the Village of Amityville, and a stamped, self-addressed envelope. Do not send a personal check.