Rushville, NY · Yates County
Application to Local Registrar for Copy of Death Record
This application lets eligible applicants request a copy of a deceased person's death record from a local registrar.
At a glance
- Issued by
- City of Rushville · Rushville, Yates County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- villageofrushville.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request copies of a death record and state the purpose for the request, your relationship to the deceased, and any capacity in which you are acting. The form asks for details about the deceased, the place and date of death, the number and type of copies requested, and the applicant's contact information. Applicants who are not a parent, child, or spouse at the time of death must submit documentation of a lawful right or claim.
Who needs it
A person seeking a death 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; the signer just signs and dates it.
How to submit this form
- 1
Download The Application
Download the death record copy application PDF.
- 2
Complete The Application
Enter the deceased person's details, your relationship and purpose, the number and type of copies requested, and your contact information.
- 3
Gather Required Attachments
Include copies of the required identification; if you are not a parent, child, or spouse at the time of death, include documentation of a lawful right or claim.
- 4
Submit To The Local Registrar
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. The signer just signs and dates it.
- 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.
- What identification must accompany the application?
- The application requires copies of either one listed form of photo ID or two listed items showing the applicant's name and address.
- What if I am not the deceased person's parent, child, or spouse?
- The form says applicants who are not the deceased person's parent, child, or spouse at the time of death must submit documentation of a lawful right or claim.
Need something notarized?
This Application to Local Registrar for Copy of Death Record doesn’t need a notary, but if you have another Rushville form that does, a commissioned online notary can help.