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Office of Vital Records 125 Worth Street CN-4 Room 133 New York N.Y. 10013-4090 SEE INSTRUCTIONS AND APPLICABLE FEES BELOW AND ON BACK DO NOT WRITE IN THIS SPACE OFFICE USE ONLY BIRTH CERTIFICATE APPLICATION Please Print Clearly 1. HOW MANY COPIES DO YOU NEED 13. HOW ARE YOU RELATED TO THE PERSON ON THIS BIRTH CERTIFICATE SELF/PARENT/OTHER please explain PLEASE PRINT YOUR MAILING AND CONTACT INFORMATION CLEARLY BELOW NAME STREET ADDRESS APT. NO. CITY STATE ZIP CODE DAYTIME PHONE NUMBER Area Code Telephone Number E-MAIL ADDRESS NOTE Copy of a birth record can be issued only to persons to whom the record of birth relates if of age or to a parent or human service organizations. It is a violation of law to make a false untrue or misleading statement or forge the signature of another on this application. Violations are a misdemeanor punishable by a fine of up to 2 000. GOV/VITALRECORDS VR 67 Rev. 01/14 IMPORTANT BIRTH CERTIFICATE INFORMATION You can obtain a birth certificate for yourself i....

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
NY VR 67
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2014 NY VR 67
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