Whitehall, NY · Washington 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 for a stated purpose.
At a glance
- Issued by
- City of Whitehall · Whitehall, Washington County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- whitehallny.org
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request copies of a birth record from the local registrar. It asks for details about the person named on the record, the birth, the applicant’s relationship and contact information, the number of copies, and the purpose of the request. The form lists fees of $30 per certified copy or No Record Certification for county districts and $10 for other districts.
Who needs it
A person requesting a birth record copy from the local registrar should complete this application and provide the required identification copies.
How to submit it
Submit the application to the local registrar with copies of the required identification. The form lists a fee of $30 per certified copy or No Record Certification for county districts and $10 for other districts.
About notarization
This application is signed without a notary; a notarized authorization is required if the requester is not a child or parent named on the requested certificate.
How to submit this form
- 1
Download the Application
Download the birth record copy application PDF.
- 2
Complete the Application
Enter the requested birth, applicant, relationship, contact, copy-count, and purpose details, then sign and date the form.
- 3
Gather Identification
Attach copies of one listed valid photo ID or two listed documents showing your name and address.
- 4
Submit to the Local Registrar
Send the application and identification copies to the local registrar with the applicable fee listed on the form.
Frequently asked questions
- Do I need a notary for the birth record copy application?
- No, the application itself is signed without a notary. If the requester is not a child or parent named on the requested certificate, the form says notarized authorization is required.
- How do I submit the birth record copy application?
- Submit the application to the local registrar with copies of the required identification. The form lists a fee of $30 per certified copy or No Record Certification for county districts and $10 for other districts.
- What identification must accompany the application?
- The application must include copies of either one listed form of valid photo ID or two listed documents showing the applicant’s name and address.
- What information does the application ask for?
- It asks for the person’s name and birth details, the applicant’s relationship and contact information, the number of copies, and the purpose for which the record is required.