Rushville, NY · Yates County
Application to Local Registrar for Copy of Birth Record
This application requests a copy of a birth record from a local registrar and is completed by the person seeking the record.
What this form is
Use this application to request a copy of a birth record from a local registrar. It asks for details about the person named on the record, the birth, the applicant, the purpose and number of copies requested, and the applicant’s relationship to the person. The form also lists identification requirements and fees; notarized authorization is required for some requests.
Who needs it
Anyone requesting a birth record copy from a local registrar should complete this 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.
About notarization
This application is signed and dated without a notary; requests from anyone other than the child or parents named on the certificate require notarized authorization.
How to submit this form
- 1
Download The Application
Download the birth record copy application PDF.
- 2
Complete The Application
Enter the birth, applicant, purpose, and copy-request details, then sign and date the form.
- 3
Gather Identification
Attach copies of one listed photo ID or two listed items showing your name and address.
- 4
Submit To The City
Submit the application 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 copy application?
- No. The application is signed and dated without a notary, but a request from someone other than the child or parents named on the certificate requires notarized authorization.
- How do I submit the birth record copy application?
- 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 applicant details, the purpose and number of copies requested, and the applicant’s relationship to the person whose record is needed.
- What identification must accompany the application?
- Include copies of one listed form of valid photo ID, or two listed items showing the applicant’s name and address. The form also notes a passport-copy requirement for certain requests from foreign countries.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary — but if you have another Rushville form that does, a commissioned online notary can help.