Rye, NY · Westchester County
Application for Correction of Death Certificate
This application requests a correction or addition to a death certificate and is completed by the physician who signed it or the person who supplied its original information.
What this form is
Use this form to request correction of information entered in error or addition of information omitted when the original death certificate was filed. The applicant identifies the death record, describes the error and requested correction, explains the reason, and lists supporting evidence. Documentary evidence is required for most corrections, with exceptions described in the instructions.
Who needs it
The physician who signed the original death certificate or the person who furnished information for it should complete and sign this application.
How to submit it
Return the form to the Correction Unit, Vital Records Section, P.O. Box 2602, Albany, NY 12220-2602, or to the Registrar of Vital Statistics for your local area.
About notarization
This document is signed without a notary; the applicant signs an affirmation under penalties of perjury and dates the form.
How to submit this form
- 1
Download The Application
Download the death certificate correction application.
- 2
Complete The Form
Identify the death record, describe the information in error and the requested correction, and explain the reason.
- 3
Gather Supporting Evidence
Include documentary evidence when required; the instructions describe exceptions and examples of acceptable documents.
- 4
Submit The Application
Return the form to the Correction Unit in Albany or to the Registrar of Vital Statistics for your local area.
Frequently asked questions
- Do I need a notary for the death certificate correction application?
- No. The applicant signs an affirmation under penalties of perjury and dates the form; the document does not require a notary.
- Who can complete the application?
- The instructions say it should be completed and signed by the physician who signed the original death certificate or the person who furnished information for it.
- What evidence should I include?
- Documentary evidence is required for most corrections. The instructions list examples such as a birth certificate, marriage record, church or synagogue record, physician's office record, or census record.
- How do I submit the application?
- Return it to the Correction Unit, Vital Records Section, at P.O. Box 2602, Albany, NY 12220-2602, or to the Registrar of Vital Statistics for your local area.