Newark Valley, NY · Tioga County
Application to Local Registrar 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 identification.
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 and birth details, the applicant’s relationship to that person, the reason for the request, and the number of copies needed. Applicants must include copies of the specified identification; requests from someone other than the child or parents named on the certificate require notarized authorization.
Who needs it
Anyone requesting a birth record copy from the local registrar must complete this application and include the required identification.
How to submit it
Submit the application to the local registrar with copies of the required identification. The form lists fees of $30 per certified copy or No Record Certification for county districts and $10 for other districts.
About notarization
This application is signed and dated without a notary; requests from someone other than the child or parents named on the certificate require notarized authorization.
How to submit this form
- 1
Download The Application
Download the birth record copy application PDF.
- 2
Complete The Form
Enter the birth details, applicant information, relationship, purpose, and number of copies requested.
- 3
Gather Identification
Include copies of either one listed photo ID or two listed documents showing your name and address.
- 4
Submit To The Local Registrar
Send the completed application and identification copies to the local registrar; the form lists applicable fees.
Frequently asked questions
- Do I need a notary for the birth record application?
- No. Sign and date the application without a notary. Requests from someone other than the child or parents named on the certificate require notarized authorization.
- How do I submit the birth record application?
- Submit the application to the local registrar with copies of the required identification. The form lists different per-copy fees for county districts and other districts.
- What identification must I include?
- Include either one listed form of valid photo identification or copies of two listed documents showing your name and address. The form specifies the acceptable documents.
- What information does the application request?
- It asks for the name and birth details on the certificate, applicant contact information and relationship, purpose of the request, and number of copies.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary — but if you have another Newark Valley form that does, a commissioned online notary can help.