Attica, NY · Wyoming County
Application for Copy of Death Record
This application lets a person request a certified copy or No Record Certification for a death record from the local registrar.
What this form is
Use this application to request a copy of a death record or a No Record Certification. It asks for information about the deceased, the applicant’s relationship and purpose, and the number of copies requested. The form requires copies of specified identification, and applicants who are not the deceased’s parent, child, or spouse at the time of death must provide documentation of a lawful right or claim.
Who needs it
Anyone requesting a death record copy or No Record Certification must complete the application and provide the required identification.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form lists a $10 fee per certified copy or No Record Certification.
About notarization
This document is signed and dated without a notary; provide the required identification copies and, if applicable, documentation of a lawful right or claim.
How to submit this form
- 1
Download the Application
Download the death record copy application for Attica.
- 2
Complete the Form
Enter details about the deceased, your relationship and purpose, and the number of copies requested; sign and date the application.
- 3
Gather Required Documents
Attach copies of the required identification and, if applicable, documentation of a lawful right or claim.
- 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 copy application?
- No. The application has a signature and date field but no notary block. Include the required identification copies and, if applicable, documentation of a lawful right or claim.
- How do I submit the death record copy application?
- Submit it to the city department named on the form; check the city website for current contact details. The form lists a $10 fee per certified copy or No Record Certification.
- What identification must I include?
- Include copies of either one listed valid photo ID or two listed documents showing your name and address, such as utility or telephone bills or a recent government agency letter.
- Who must provide proof of a lawful right or claim?
- Applicants who are not the deceased’s parent or child, or the deceased’s spouse at the time of death, must submit documentation of a lawful right or claim.