Walworth, NY · Wayne County
Mail-In Application for Genealogical Services
This application is for people requesting birth, death, or marriage records for genealogy research from the New York State Department of Health.
At a glance
- Issued by
- City of Walworth · Walworth, Wayne County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- townofwalworthny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application only for genealogy requests for birth, death, or marriage records. It asks for details about the record, the applicant’s relationship to the person, the purpose of the request, and where to send the record. The applicant signs and dates the form, then mails it with payment and copies of any required documentation to the Vital Records Section.
Who needs it
Anyone requesting a birth, death, or marriage record from the New York State Department of Health for genealogy research should complete this application.
How to submit it
Mail the signed application, check or money order payable to the New York State Department of Health, and copies of any required documentation to the Vital Records Section, Certification Unit, P.O. Box 2602, Albany, NY 12220-2602.
About notarization
This application does not require a notary; the applicant signs and dates it and includes copies of any required documentation.
How to submit this form
- 1
Download the Application
Download and print the Mail-In Application for Genealogical Services.
- 2
Complete the Form
Fill in the applicable birth, death, or marriage record details, along with the requested applicant information.
- 3
Gather Payment and Documents
Include a check or money order payable to the New York State Department of Health and copies of any required documentation.
- 4
Sign and Mail the Application
Sign and date the form, then mail it with payment and documentation to the address listed in the instructions.
Frequently asked questions
- Do I need a notary for the Mail-In Application for Genealogical Services?
- No. The application does not require a notary; the applicant signs and dates it and includes copies of any required documentation.
- How do I submit the genealogical services application?
- Mail the signed application, payment by check or money order, and copies of any required documentation to the Vital Records Section, Certification Unit, P.O. Box 2602, Albany, NY 12220-2602.
- What records can I request with this application?
- The application has sections for birth, death, and marriage records and is intended for genealogy requests.
Need something notarized?
This Mail-In Application for Genealogical Services doesn’t need a notary, but if you have another Walworth form that does, a commissioned online notary can help.