Newark Valley, NY · Tioga County
Application to Local Registrar for Copy of Death Record
This application lets eligible people request a certified copy or no-record certification for a death record from a local registrar.
At a glance
- Issued by
- City of Newark Valley · Newark Valley, Tioga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- sbo.rtt.mybluehost.me
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request a copy of a death record or a no-record certification. It asks for information about the deceased, the applicant’s relationship and purpose, and the number of copies requested; the stated fee is $10 per certified copy or no-record certification. Applicants must include copies of the required identification, and those without a specified close relationship must provide documentation of a lawful right or claim.
Who needs it
Anyone requesting a death record copy or no-record certification must complete this application and provide the identification and any relationship documentation it requires.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed and dated without a notary; the form asks the applicant to sign and date it and lists no notarized attachment.
How to submit this form
- 1
Download The Application
Download the death record copy application.
- 2
Complete The Application
Enter the deceased’s details, your relationship and purpose, and the number of copies requested; sign and date the application.
- 3
Gather Required Attachments
Include copies of the required identification and, if applicable, documentation of a lawful right or claim.
- 4
Submit To The City
Submit the application to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the death record copy application?
- No. This application is signed and dated without a notary; the form asks for no notarized attachment.
- How do I submit the death record application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What identification must I include?
- Include copies of either one listed form of valid photo identification or two listed documents showing your name and address.
- What is the fee for a death record copy?
- The form states a fee of $10 per certified copy or no-record certification.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary, but if you have another Newark Valley form that does, a commissioned online notary can help.