Application for Copy of Marriage Certificate

Document Sample
Application for Copy of Marriage Certificate Powered By Docstoc
					Application for Copy of Birth Certificate
______________________________________________________________________________

             Information Page – Application for Copy of Birth Certificate
______________________________________________________________________________

General Instructions:
· Use this application only if you are the person named on the birth certificate or that person’s
parents.

· Use this application only if the birth occurred in the City of Hudson.

· Print a copy of this application, complete and sign.

· If delivery is to a P.O. Box or to a third party you must submit, with this application, a
notarized statement signed by the applicant and a copy of the applicant’s driver’s license.

· Mail application with a money order, $10.00 per copy, payable to the City of Hudson and a
copy of required identification (see below).

                                       Hudson City Clerk
                                           City Hall
                                       520 Warren Street
                                       Hudson, NY 12534


___________________________________________________________________________

Identification Requirements – Application must be submitted with copies of either A or B:

       A. One (1) of the following forms of valid photo-ID:
             · Driver License
             · Non-Driver Photo-ID Card
             · Passport
             · Other government issued photo-ID

       B. Two (2) of the following showing the applicant’s name and address:
             · Utility or telephone bills
             · Letter from a government agency dated within the last six months.
                                           Application for Copy of Birth Certificate
______________________________________________________________________________
Required ID must be included with application. Fee: $10.00 per copy payable with money order to City of Hudson

Send to:
       Hudson City Clerk
       City Hall
       520 Warren Street
       Hudson, NY 12534
______________________________________________________________________________
Name: (as listed on birth certificate)                       Date of Birth:

______________________________________________________________________________
Town, city or village where birth occurred:                   Name of hospital where birth occurred: (if known)

______________________________________________________________________________
Maiden Name of Mother: (as listed on birth certificate)


           First                     Middle                                Maiden Last Name___________________
Name of Father: (as listed on birth certificate)


          First                     Middle                               Last Name__________________________

Purpose for    Passport        Employment  Drivers License  Veteran’s benefits
Which Record  Social Security  Working Papers  Marriage License  Court proceeding
Is required:   Retirement  School entrance  Welfare Assistance  Armed Forces
(check one)   Other (specify)__________________________
______________________________________________________________________________
What is your relationship to                                    If attorney, give name and relationship of your client
Person whose record is required?                                To person whose record is required:
(If self, state “SELF”)

______________________________________________________________________________
Signature of Applicant:             Print Name:                   Date:

______________________________________________________________________________
Address of Applicant (Street/Mailing): If mailing address is a PO Box or third party, you must submit with
this application a notarized statement signed by the applicant and a copy of the applicant’s driver’s license:

_______________________________________________


_______________________________________________                                Number of copies requested:
Telephone Number:
(     )                                                                               _____________
_______________________________________________

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:10
posted:10/3/2012
language:English
pages:2