Newark Valley, NY · Tioga County
Application for Correction of Certificate of Death
This application requests a correction or addition to a death certificate and is completed by the physician who signed it or the person who supplied its original information.
What this form is
Use this form to correct information entered in error or add information omitted when the original death certificate was filed. The physician who signed the original certificate or the person who furnished its information must complete and sign it. Documentary evidence is required for most corrections, with listed exceptions; other changes or alterations require a court order.
Who needs it
The physician who signed the original death certificate or the person who furnished its original information completes and signs the application.
How to submit it
Return the form to the Correction Unit, Vital Records Section, P.O. Box 2602, Albany, NY 12220-2602, or to the Registrar of Vital Statistics for your local area. Include documentary evidence when required.
About notarization
This form is signed and dated without a notary; include documentary evidence for corrections that require it, but the form does not require notarization.
How to submit this form
- 1
Download The Application
Download the Application for Correction of Certificate of Death.
- 2
Complete And Sign The Form
Enter the certificate details, describe the error or omission, explain the reason, and have the eligible person sign and date the application.
- 3
Gather Required Evidence
Include documentary evidence for corrections that require it. The instructions list exceptions for certain additions and minor spelling or date changes.
- 4
Submit The Application
Send the form to the Correction Unit at the listed Albany address or to the Registrar of Vital Statistics for your local area.
Frequently asked questions
- Who can complete the death certificate correction application?
- The form instructions say it should be completed and signed by the physician who signed the original death certificate or the individual who furnished information for it.
- What evidence must I include with the application?
- Documentary evidence is required for most corrections. The instructions list exceptions, including adding information that was unavailable when the certificate was filed and certain minor spelling changes.
- Do I need a notary for the death certificate correction application?
- No. The form is signed and dated without a notary. Include documentary evidence for corrections that require it; the form does not require notarization.
- How do I submit the death certificate correction application?
- Return it to the Correction Unit, Vital Records Section, P.O. Box 2602, Albany, NY 12220-2602, or to the Registrar of Vital Statistics for your local area. Include evidence when required.
Need something notarized?
This Application for Correction of Certificate of Death doesn’t need a notary — but if you have another Newark Valley form that does, a commissioned online notary can help.