Penn Yan, NY · Yates County
Birth Record Application
This application requests a copy of a birth record and is completed by the person seeking the record or their representative.
What this form is
Use this application to request a copy of a birth record from the local registrar. It asks for the person's name, date and place of birth, parents' names, the number of copies requested, the reason for the request, and the applicant's relationship and contact information. The applicant signs and dates the form, and must present one of the identification types listed on it.
Who needs it
Anyone requesting a copy of a birth record, including an attorney applying for a client, can use this application.
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 and dated without a notary; present one listed type of identification, and the form mentions no sworn or notarized attachment.
How to submit this form
- 1
Download The Application
Download the Birth Record Application PDF.
- 2
Complete The Application
Enter the birth, parent, request-purpose, relationship, and applicant contact details.
- 3
Gather Identification
Prepare one type of identification listed on the form; it must be presented for a copy to be issued.
- 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 application asks the applicant to sign and date it, but has no notary block. Present one of the listed types of identification; no notarized attachment is mentioned.
- How do I submit the Birth Record Application?
- The document does not give a submission address or method. Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application ask for?
- It asks for birth and parent details, the number of copies, the reason for the request, the applicant's relationship to the person, and contact information.
- What identification must I provide?
- The form says not to issue a copy unless one listed type is presented, such as a driver's license, passport, military ID, or two utility bills showing your name and address.
Need something notarized?
This Birth Record Application doesn’t need a notary — but if you have another Penn Yan form that does, a commissioned online notary can help.