Pelham, NY · Westchester County
Application to Local Registrar for Copy of Death Record
This application lets a person request a copy of a death record from the Village of Pelham and provide information about the deceased and applicant.
What this form is
Use this application to request a copy of a death record from the Village of Pelham. It asks for details about the deceased, the applicant’s purpose and relationship to the deceased, and the applicant’s contact information. Submit it with the $10.00 per copy payment, a copy of valid photo identification, and a self-addressed, stamped return envelope.
Who needs it
Anyone requesting a death record copy from the Village of Pelham should complete the application and provide the listed payment and supporting items.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed without a notary; an attorney must include a signed and notarized authorization letter stating the client’s relationship to the deceased.
How to submit this form
- 1
Download The Application
Download the Village of Pelham application for a copy of a death record.
- 2
Complete The Application
Fill in the deceased’s information and the applicant’s purpose, relationship, capacity, and contact details; then sign and date it.
- 3
Gather Required Items
Include $10.00 per copy by check or cash, 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 death record application?
- No. The applicant signs and dates the application without a notary. If an attorney applies, a signed and notarized authorization letter is required.
- What should I include with the application?
- Include $10.00 per copy by check or cash, a copy of valid photo identification, and a self-addressed, stamped return envelope.
- What information does the application request?
- It requests information about the deceased, including name and date of death, plus the applicant’s purpose, relationship, capacity, signature, date, and address.
- How do I submit the death record application?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary — but if you have another Pelham form that does, a commissioned online notary can help.