Esopus, NY · Ulster County
Application to a Local Registrar for a Copy of a Birth Record
This application requests a copy of a birth record from a local registrar and is completed by the person seeking the record.
What this form is
This application is for requesting a copy of a birth record from a local registrar. It asks for the person’s name, date and place of birth, parents’ names, the number of copies requested, and the purpose for the record. The applicant also provides their relationship to the person named, contact details, address, and signature and date.
Who needs it
A person requesting a birth record copy from a local registrar should complete this application with the requested identifying and contact information.
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 document does not identify any notarized attachment or related step.
How to submit this form
- 1
Download the Application
Download the birth record copy application.
- 2
Complete the Application
Enter the requested birth details, purpose, relationship, contact information, and address.
- 3
Sign and Date
Sign and date the application.
- 4
Submit to the City
Submit it 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 birth record request?
- No. The application asks the applicant to sign and date it, and it does not identify a notarized attachment or related step.
- How do I submit the birth record request?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application ask for?
- It asks for birth details, parents’ names, the number of copies requested, the purpose for the record, the applicant’s relationship, contact details, address, signature, and date.
Need something notarized?
This Application to a Local Registrar for a Copy of a Birth Record doesn’t need a notary — but if you have another Esopus form that does, a commissioned online notary can help.