The NYC Health VR 66 form serves as an official request for a death certificate in New York City, providing a structured format for applicants to supply necessary information about the deceased and themselves. It specifies who can request a death certificate, outlines the required identification and documentation, and details the applicable fees. This form is vital for those needing to establish their relationship to the deceased, complete estate matters, or for other legal purposes.
In a bustling metropolis like New York City, the process of obtaining vital records, such as a death certificate, is streamlined by forms like the NYC Health VR 66. This comprehensive document serves multiple purposes, ranging from the registration to vote to the intricate details required for a death certificate application. Situated at the Office of Vital Records at 125 Worth Street, the form emphasizes clarity and precision in its instructions, ensuring applicants understand the necessary steps and associated fees. Whether the requester seeks to know the date of death, the deceased’s last known address, or the need for a letter of exemplification, the VR 66 form covers these bases in a methodical manner. Furthermore, it delineates the qualifications for those eligible to request this sensitive information, restricting access to closely related individuals or those with a legal or proper interest, reflecting an adherence to privacy and legal standards. Additionally, the form guides users through various ordering methods, including online, walk-in, or by mail options, while highlighting the ID requirements and emphasizing the illegality of falsifying information. With stringent measures to prevent misuse, this form not only facilitates access to vital records but also upholds the integrity of the process, marking an essential component of the city’s health documentation infrastructure.
Register to vote:
http://www.nyccfb.info/public/VRC/registeringToVote.aspx?sm=public_rtv
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
DEATH CERTIFICATE APPLICATION
(Please Print Clearly)
1. LAST NAME AT TIME OF DEATH
2. FIRST NAME
3. ☐ FEMALE
☐ MALE
4. DATE OF DEATH
5. IF YOU DON’T KNOW THE EXACT DATE OF DEATH
BEGIN
END
SEARCH
MM
DD
YYYY
6. PLACE OF DEATH
7. BOROUGH
8. AGE
9. HOW MANY COPIES
10. DO YOU NEED A LETTER OF
MAN ☐ BRONX ☐ BKLYN ☐ QUEENS ☐ SI ☐
DO YOU NEED?
EXEMPLIFICATION ☐ YES ☐ NO
11. SPOUSE OR DOMESTIC PARTNER’S NAME
12. LAST KNOWN ADDRESS
13. OCCUPATION OF DECEASED
14. FATHER/PARENT’S NAME
/ʼ
16. SOCIAL SECURITY NUMBER
17. CERTIFICATE NUMBER (if known)
18. WHY DO YOU NEED THIS CERTIFICATE?
19. WHAT IS YOUR RELATIONSHIP TO DECEASED?
PLEASE PRINT YOUR MAILING AND CONTACT INFORMATION CLEARLY BELOW
NAME
DAYTIME
PHONE
NUMBER
Area Code
Telephone Number
E-MAIL
ADDRESS
20. DO YOU NEED THE CAUSE OF DEATH? ☐ YES
☐ NO
21. FEES
You may only obtain cause of death if your relationship to the deceased is
$15 per copy x _________ copies
$ _________
listed below:
Cost of certified copy includes a two consecutive year search
Please check the appropriate box
☐ Spouse or Domestic Partner ☐ Parent or Child ☐ Sibling
$3 for each extra year searched x _______ years
☐ Grandparent ☐ Grandchild
Total Amount Enclosed: $ _________
☐ Person in control of disposition on death certificate
IF RECORD IS NOT ON FILE, A CERTIFIED “NOT FOUND STATEMENT” WILL BE ISSUED.
APPLICATIONS SUBMITTED BY MAIL MUST
NOTARY PUBLIC SEAL
22. CUSTOMER SIGNATURE. IF BY MAIL MUST BE NOTARIZED
BE NOTARIZED
By my signature below, I state I am the person whom I represent myself to be
herein. I affirm the information within this form is complete and accurate. In
STATE OF
addition, I acknowledge that misstating my identity or assuming the identity of
another person including forging a signature may subject me to a misdemeanor
COUNTY OF
and violators may also be subject to a fine of up to $2,000.
SUBSCRIBED AND SWORN BEFORE ME:
THIS ______ DAY OF _______________ , 20 ____
Signature (required)
Date
NOTARY PUBLIC SIGNATURE
Credit cards are not accepted for mail-in orders. Please make your check or money order payable to the NYC Department of Health and Mental Hygiene. If from a foreign country, send an international money order or check drawn on a U.S. bank. Cash is not accepted by mail or in person.
ORDER DEATH CERTIFICATES QUICKLY AND SECURELY AT WWW.NYC.GOV/VITALRECORDS
VR 66 (Rev. 01/15)
IMPORTANT DEATH CERTIFICATE INFORMATION
‚You can obtain a death certificate if you are the spouse, domestic partner, parent, child, sibling, grandparent or grandchild of the decedent, or if you establish your right to obtain this document (see documentation requirements below).
‚All death certificates are mailed, usually within 2-4 weeks. If there is an urgent need, and documentation is provided, you can request expedited services and you will be called to pick up the certificate in 5-7 business days.
‚Falsifying information, including forging a signature, to obtain a death certificate is a misdemeanor and violators may also be subject to a fine of up to $2,000 per violation.
‚Submitting fraudulent identification is a crime and violators are subject to prosecution.
‚Please see below for identification requirements, fees and other important information.
‚ID requirements are subject to change.
3 WAYS TO ORDER A NEW YORK CITY DEATH CERTIFICATE
●Online: Visit www.nyc.gov/vitalrecords to order using a credit card, debit card or electronic check. “Only spouses, domestic partners, parent, siblings, grandparent, grandchild, or person in charge of the disposition (informant) may submit orders online”
●Walk-In: Go to 125 Worth Street in Lower Manhattan and use the Lafayette Street (handicapped accessible) or Centre Street entrances. We are open Monday through Friday 9:00AM – 3:30PM. Lines are shortest
in the morning.
●By Mail: Applications submitted by mail must be signed in the presence of a Notary Public. Mail your application to 125 Worth Street, CN-4, New York, NY 10013. Be sure to include a self-addressed, stamped, envelope with your check or money order. You also will need to provide a photocopy of the required identification and any necessary documentation (see below).
Identification (ID) Requirements including the deceased’s spouse, domestic partner, parent, sibling, grandparent, grandchild, or person in charge of the disposition (informant)
We accept any of the following, IF it includes your photo, your signature and is unexpired:
●Driver’s License or Non-driver’s ID Card
●IDNYC Municipal ID
●Passport
●Government ID
●Employment ID with pay stub
If you don’t have any of the above, we also accept:
●Inmate photo ID with release papers
●Two different documents as indicated below if they show your name and address and are dated within the past 60 days, we will MAIL the certificate
m Utility or telephone bills
m Official government mail that you have received
If you do not have the items required above, you may email nycdohvr@health.nyc.gov for additional information and options.
Documentation Requirements for applicants NOT related to the deceased
If you are not related to the deceased, you need to establish your right to obtain a death certificate. You may obtain a death certificate if you are the legal representative of the estate, a party with a property right to protect or assert, or if you can specify another judicial or other proper purpose.
●Insurance Policy
●Will
●Bank Book or statement
●Property Deed
●Other document showing entitlement
If you are unable to provide the required documents, ask us for help by calling 311 or 1-212-NEW-YORK if you are outside of New York City.
After completing the NYC Health VR 66 form for a death certificate application, your next steps involve careful adherence to identification and payment protocols. The form enables qualified individuals, namely immediate family members or legal representatives of the deceased, to formally request a death certificate. Whether you apply by mail, online, or in person, it's important to provide all required information and documents to avoid delays.
After completing and signing the form, if you are mailing it, attach a check or money order payable to the NYC Department of Health and Mental Hygiene. Remember, cash payments are not accepted. Include a photocopy of the required identification and any necessary documentation specific to your relationship to the deceased or legal standing. Finally, mail your application with all attachments to the Office of Vital Records at the provided address. The processing time can vary, but expect to receive the death certificate usually within 2-4 weeks unless expedited service is requested and approved.
What is the NYC Health VR 66 form used for?
The NYC Health VR 66 form is utilized for applying for a death certificate in New York City. Individuals who have a direct relationship to the deceased, such as a spouse, domestic partner, parent, child, sibling, grandparent, or grandchild, or can establish a rightful claim, can apply using this form. It requires detailed information about the deceased, the reason for requesting the certificate, the applicant's relationship to the deceased, and contact information.
How many copies of the death certificate can I request, and what are the fees involved?
Applicants can request multiple copies of the death certificate as needed. The fee for each certified copy is $15. If the search for the death certificate spans more than two consecutive years, an additional fee of $3 for each extra year searched is required. The total amount due will depend on the number of copies requested and the length of the search required.
Can anyone request a death certificate?
Not everyone is eligible to request a death certificate. Only certain relationships to the deceased permit one to obtain a death certificate. These include the deceased's spouse or domestic partner, parent, child, sibling, grandparent, grandchild, or a person listed as in charge of the disposition on the death certificate. If the applicant is not directly related, they must demonstrate a legal or proper purpose for needing the certificate, such as being the legal representative of the deceased's estate.
What identification is required to order a death certificate?
To order a death certificate, you must provide identification that includes your photo, signature, and is not expired. Acceptable forms of ID include a Driver’s License, Non-driver’s ID Card, Passport, Government ID, or Employment ID with a pay stub. If you do not possess these, alternative documents such as an inmate photo ID with release papers, or two different billing documents showing your name and address, might be accepted. Specific needs and exceptions can be addressed by contacting the Office of Vital Records directly.
What are the methods to order a death certificate in New York City?
There are three ways to order a New York City death certificate: online, in person, or by mail. Online orders can be placed at the official website using a credit card, debit card, or electronic check. For in-person requests, you can visit the Office of Vital Records at 125 Worth Street in Lower Manhattan. Mail-in applications require a notarized signature and should include the necessary fees and a self-addressed, stamped envelope for return.
What should I do if the death record is not found?
If the death record you requested is not found, a certified "Not Found Statement" will be issued by the Office of Vital Records. This document serves as official confirmation that a thorough search was conducted and no matching record was found based on the information provided. For additional steps or to conduct another search, applicants may need to provide more detailed or corrected information to narrow down the search parameters.
Filling out NYC Health VR 66 form, which is the application for a death certificate, is a vital process that must be approached with precision and a clear understanding of the requirements. Given its significance, some common mistakes are frequently encountered. These not only delay the processing of the application but can also cause unnecessary complications. Being aware of these errors can help to ensure the process is completed smoothly and efficiently.
In conclusion, filling out the NYC Health VR 66 form demands attention to detail and a thorough understanding of the requirements. By avoiding these common mistakes—such as providing incomplete information, misunderstanding the fees, or misidentifying one's relationship to the deceased—applicants can streamline the process. This diligence ensures that the necessary documents are obtained in a timely and fuss-free manner, helping to settle the affairs of the deceased more efficiently.
When handling affairs after the passing of a loved one, obtaining a death certificate via the NYC Health VR 66 form is essential. However, this form is often only one of many documents needed during such a time. Various other forms and documents might be used along with it, each serving a critical function in legal, financial, and personal contexts.
Each document plays its part in the larger process of finalizing the deceased's affairs, from accessing funds to transferring property. It's important to manage these documents carefully and consult with appropriate professionals to ensure legal compliance and respect for the deceased's wishes.
The New York State Application for a Birth Certificate closely mirrors the NYC Health VR 66 form in several respects. Both applications require specific personal details about the individual whose record is being requested, such as full name, date, and place of birth or death, and parental information. Additionally, they both stipulate conditions under which one may obtain these documents, including proof of relationship or legal grounds for acquiring the record. Moreover, each form outlines applicable fees, mandates for notarization for mail orders, and clearly states penalties for falsification of information or forgery.
A Marriage License Application shares similarities with the NYC Health VR 66 form, particularly in terms of documentation and verification requirements. Like the death certificate application, it asks for personal details about the parties involved, including past marital status, and necessitates notarization when submitted by mail. Both forms also include a section for official use only and highlight the legal ramifications of submitting fraudulent information. Furthermore, each document requires specific identification to process the application, ensuring the legitimacy of the request.
The Passport Application Form for the United States stands as another document bearing resemblance to the NYC Health VR 66 form. It requests detailed personal information, including name, date, and place of birth, much like the death certificate application. Verification of identity through specific forms of ID, reasons for the document request, and countersignatory or notarization requirements echo the provisions seen in the NYC form. Both emphasize the legal consequences of false statements and the importance of accuracy in the information provided.
The Application for a Social Security Card can also be compared to the NYC Health VR 66 form. Although it serves a different function, this application similarly gathers comprehensive personal data, including information about parents and marital status, similar to what might be relevant in the event of a death certificate request for determining next of kin. Each form has strict guidelines for the types of ID that can be submitted in support of the application, aiming to prevent identity theft and ensure proper assignment of records.
Property Deed Transfer Forms share a procedural likeness with the NYC Health VR 66 form in how they handle personal information, legal declarations, and notarization aspects. While their purposes differ significantly, both require the submission of detailed personal or entity-related information and necessitate legal acknowledgment through notarization or witnessing, highlighting the gravity and formal nature of these transactions. Moreover, they both include measures to safeguard against fraudulent claims and clearly outline the penalties for such actions.
Life Insurance Beneficiary Claim Forms echo the NYC Health VR 66 form's requirement for detailed personal information and proof of claim (i.e., relationship to the deceased). Both necessitate information that substantiates the requestor's right to the requested document or benefit, underlined by legal attestations concerning the truthfulness of the provided information. Additionally, they include stringent ID requirements for processing, aiming to protect against fraud and ensure that requests are legitimate.
Finally, the Voter Registration Form, while unique in purpose, shares commonalities with the NYC Health VR 66 form. Both are official documents requiring personal identification information and signature verification. Each form also serves as a gateway to exercising certain rights or obtaining specific credentials, underpinned by serious legal obligations and potential consequences for fraudulent submissions. While one initiates voter eligibility, the other facilitates access to vital records, both integral to civic processes and personal rights within society.
When dealing with the NYC Health VR 66 form, which is a death certificate application, ensuring accuracy and compliance with the provided guidelines is of utmost importance. Here is a curated list of dos and don'ts that will guide you through the proper completion of this sensitive document.
Following these guidelines will help streamline the process of obtaining a death certificate through the NYC Health VR 66 form. Remember, this process is not just about filling out a form; it's about ensuring that the information provided respects the memory of the deceased while also meeting the legal requirements set forth by the City of New York.
Several misconceptions surround the NYC Health VR 66 form, which is essential for applying for a death certificate in New York City. Clarifying these misunderstandings can streamline the application process and help applicants avoid unnecessary complications. Here are five common misconceptions and the realities behind them:
Understanding these key points about the NYC Health VR 66 form can help applicants navigate the process more effectively, ensuring they comply with requirements and make informed decisions about how to proceed. Keeping these misconceptions in mind can also prevent delays and ensure that the application process goes smoothly.
Understanding the NYC Health VR 66 form, used for requesting death certificates, is vital for smooth processing. Here are key takeaways that can assist you in completing the application accurately and efficiently:
Moreover, the application reminds applicants that falsifying information is a punishable offense, underscoring the importance of honesty throughout the process. Whether you choose to apply online, in person, or by mail, each method has specific requirements and instructions for a smooth application experience.
Lastly, knowing that death certificates are usually mailed within 2-4 weeks, with an option for expedited service under certain conditions, allows for better planning and management of your needs related to the certificate.
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