Whitehall, NY · Washington County
Application to Local Registrar for Copy of Birth Record
This application lets people request a copy of a birth record from the local registrar and provide the details and identification required for the request.
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 a copy of a birth record from the local registrar. It asks for the person’s name and birth details, the number of copies requested, the purpose of the request, the applicant’s relationship to the person, and the applicant’s contact information. Include copies of the required identification; the form lists different fees for county districts and other districts.
Who needs it
Anyone requesting a birth record copy from the local registrar must complete this application and provide the identification listed on the form.
How to submit it
Submit the application to the local registrar. The form lists a fee of $30.00 per certified copy or No Record Certification for county districts and $10.00 for other districts.
About notarization
This application is signed and dated without a notary; if the requester is not the child or a parent named on the certificate, the form requires notarized authorization.
How to submit this form
- 1
Download the Application
Download the birth record copy application PDF.
- 2
Complete the Application
Enter the requested birth details, number of copies, purpose, relationship to the person, and applicant contact information.
- 3
Gather Identification
Include copies of either one listed valid photo ID or two listed documents showing the applicant’s name and address.
- 4
Submit to the Local Registrar
Submit the application to the local registrar. Check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the birth record copy application?
- No, the application itself is signed and dated without a notary. If the requester is not the child or a parent named on the certificate, the form requires notarized authorization.
- How do I submit the birth record copy application?
- Submit the completed application to the local registrar. The form does not provide an address or other contact details, so check the city website for current information.
- What identification must accompany the application?
- Include copies of either one listed valid photo ID or two listed documents showing the applicant’s name and address. The form lists examples for both options.
- What fees does the form list?
- The form lists $30.00 per certified copy or No Record Certification for county districts, and $10.00 for other districts.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary, but if you have another Whitehall form that does, a commissioned online notary can help.