Esopus, NY · Ulster County
Request for Death Record
This application lets a person request a copy of a death record or a No Record Certification from Esopus’s Local Registrar.
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, including name, date and place of death, and parents’ names, as well as the applicant’s relationship, purpose, contact details, and requested number of copies. The form lists a $10.00 fee per copy.
Who needs it
Anyone requesting a death record copy or No Record Certification from the Esopus Local Registrar can use this application.
How to submit it
The form lists a $10.00 fee per copy or No Record Certification and says not to send cash or stamps. Submit it to the city department named on the form; check the city website for current contact details.
About notarization
No notary is required for this document; the applicant signs and dates the request, and the form lists no notarized or sworn attachment.
How to submit this form
- 1
Download The Application
Download the Request for Death Record PDF.
- 2
Complete The Request
Provide the requested information about the deceased and applicant, then enter the number of copies requested.
- 3
Review Supporting Materials
The form does not list attachments. Check with the city for any current submission requirements.
- 4
Submit To The City
Submit the application to the city department named on the form. Do not send cash or stamps.
Frequently asked questions
- Do I need a notary for a death record request?
- No. The applicant signs and dates this request; the form lists no notarized or sworn attachment.
- How do I submit the death record request?
- Submit it to the city department named on the form; check the city website for current contact details. The form says not to send cash or stamps.
- What information does the application ask for?
- It asks for details about the deceased, the applicant’s relationship and purpose, the applicant’s contact information, and the number of copies requested.
- What is the listed fee?
- The form lists $10.00 per copy or No Record Certification.
Need something notarized?
This Request for Death Record doesn’t need a notary — but if you have another Esopus form that does, a commissioned online notary can help.