Pelham, NY · Westchester County
Application to Local Registrar for Copy of Birth Record
This application lets an applicant request a copy of a birth record from the Village of Pelham’s Local Registrar.
What this form is
Use this application to request a copy of a birth record from the Village of Pelham’s Local Registrar. It asks for the person’s name, date and place of birth, parents’ names, number of copies, and reason for the request, along with the applicant’s contact details and signature. The form lists required payment and supporting materials.
Who needs it
Anyone requesting a birth record copy from the Local Registrar should complete this application and provide the listed materials.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
The applicant signs and dates this form without a notary; an attorney must provide a signed and notarized authorization letter.
How to submit this form
- 1
Download The Application
Download the birth record copy application.
- 2
Complete The Form
Provide the certificate and applicant information, purpose for the record, and your signature and date.
- 3
Gather Required Materials
Include payment, a copy of valid photo identification, and a self-addressed, stamped return envelope.
- 4
Submit The Application
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 application?
- No. The applicant signs and dates this form without a notary. If an attorney applies, the form requires a separate signed and notarized authorization letter.
- How do I submit the birth record application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What must I include with the application?
- The form lists $10 per copy, payable by check or cash, a copy of valid photo identification, and a self-addressed, stamped return envelope.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary — but if you have another Pelham form that does, a commissioned online notary can help.