Type Full Name :
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Instructions for obtaining a copy of Non-Genealogical Vital Records
  • Non-Genealogical Records are births occurring within the last eighty (80) years or if the individual is still living, marriages occurring within the last fifty (50) years, deaths occurring within the last forty (40) years and all civil union and domestic partnership records.
  • Certified Copies have the raised seal of the office issuing the record and are always issued on State of New Jersey safety paper. Certified copies may be used to establish identity and are legal documents.
  • Certifications are issued on plain paper with no seal and clearly indicate they are not valid for establishing identity or for legal purposes. Certifications are generally useful for genealogy. Certifications of death records do not contain the Social Security Number or the Cause of Death medical terminology.
Applications for a certification or certified copy of Non-Genealogical record requires the applicant to provide a completed application, valid proof of identity**, payment of the fee and, if requesting a certified copy, proof that establishes you are:
  • the subject of the record;
  • the subject's parent, legal guardian or legal representative;
  • the subject's spouse/civil union partner, domestic partner, child, grandchild or sibling, if of legal age;
  • a state or federal agency for official purposes; or
  • requesting pursuant to a court order.
**Acceptable proofs of identity are: Valid photo driver's license or photo non-driver's license with current address OR valid driver's license without photo and an alternative form of ID with current address OR two (2) alternate forms of ID, one of which must show the current address. Alternate forms of ID are:
  • Vehicle Registration
  • Vehicle Insurance Card
  • Voter Registration
  • US/Foreign Passport
  • Permanent Resident Card (green card)
  • Immigrant Visa
  • Federal/State ID
  • County ID
  • School ID
  • Utility Bill (within previous ninety (90) days)
  • Bank Statement (within previous ninety (90) days)
  • Tax Return or W-2 for current or previous year
Requests for records to be mailed to an address other than that which appears on the requestor's ID must be accompanied by a notarized letter which includes:
  1. The alternate address, and
  2. A written requestor to mail records to this alternate address.
People who are homeless can have a social worker or the coordinator of the homeless shelter where they are temporarily residing submit a request on behalf of the homeless person. The request must be on their agency letterhead and provide the identifying information on the homeless person's vital record. The request must be accompanied by proof of employment by the agency and valid identification. The resulting copy of the vital record will be mailed to the agency.

People who are incarcerated can provide legal imprisonment, conviction papers or release documents that include the name, social security number and all possible aliases used in the past or identification from a prison/probation official.

Please do not send in original ID documents. Only copies are required.

The {[DEP]} charges $10.00 for EACH Certified Copy.

All requests are processed:
Monday, Wednesday, Thursday 8AM – 4:30PM
Tuesday 8:30AM - 8:00PM
Friday 8:00AM - 12:00 Friday

By:
Leonia Health Department
Vital Statistics and Registry
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}

Same-day Walk-in Service Processing time is approximately 15 minutes
Payment accepted: cash or money order
Online Requests Processing time is approximately 1-3 business days
Payment accepted: credit card

If you are requesting a certification (an informational copy of a vital record not valid for legal purposes), you do not need to provide proof of relationship.
  • If you are looking for a certified copy of:
    • Your own birth certificate and you have assumed your spouse's/civil union partner's surname:
    You must provide a copy of the certified copy of your marriage/civil union certificate to link the name on your current ID to the name on your birth certificate.
    Your child's birth certificate:
    You don't need any additional documents.
    Your spouse's/civil union partner's birth certificate:
    You must provide a copy of your marriage/civil union certificate.
    Your parent's or sibling's vital record:
    You must provide a copy of your birth certificate.
    If you have assumed your spouse's/civil union partner's last name you must also provide a copy of your marriage/civil union certificate to link the name on your current ID to the name on your birth certificate.
    Your grandparent's vital record:
    You must establish that you are the person's grandchild by providing proof that links the name on your ID to the name of the grandparent.
    For example, if you changed your last name after marriage/civil union and want a grandparent's vital record, you must:
    1. Provide your marriage/civil union certificate to show your name at birth,
    2. Provide your birth certificate to identify your parent, and
    3. Provide the parent's birth certificate to identify the grandparent.
  • If you are not a person qualified to get a certified copy of a record but
    You are helping a person receive a certified copy of a vital record they are eligible to receive:
    You must show your valid ID and a notarized, written release authorizing you to get the record on that person's behalf OR, you can supply a written release from the person you are helping along with a copy of that person's valid photo ID.
  • If you are an attorney
    • Who is executor of an estate:
    You must supply proof of appointment as the executor.
    Who is the legal representative of the executor of an estate:
    You must supply proof of legal retainer by the executor and proof of the appointment of the individual as the executor.
    Who is the legal representative of an individual that is eligible to receive a certified copy of a vital record:
    You must supply proof of legal retainer by the eligible individual and their proof of relationship.
    Who needs a certified copy of a vital record and you are not the legal representative of an eligible person:
    You must obtain a court order directing the State Registrar to issue a certified copy of the record. A subpoena is not sufficient to issue a copy of a vital record.
{[CNAME]}
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
By signing, I hereby certify that I am the applicant named above and that I am authorized to request a certified copy of the record for the above named individual. I understand that penalties are described by law for misrepresentation on this request.
Required Documents
Fee Schedule
State *
Vital Records Request
Applicant Details
The amount due is $10.00 for EACH Certified Copy. Please be advised that In order to receive your requested documents all payments should be made to the Borough of Leonia.
Certification
Current Mailing Address (must match address on ID)
City *
Please attach the necessary proofs of identity and relationship, as set out at the top. *
First Name *
Amount Due
Email *
Middle Name
Last Name *
Phone # *
Current Mailing Address *
Applicant Signature *
  • Request
  • Birth
  • Marriage, Civil Union, Domestic Partnership
  • Death
Other (specify)
Veteran's Benefits
Medicare
Driver's License
Request for *
Passport
Welfare/Disability
* Please note that if you pick the USPS mail option, your ID needs to match the requested mail address.
Fulfillment Method
School/Sports
Social Security Card/Benefits
What is the purpose of your request * (select as many as necessary)
Type of record *
Relationship to person on record *
Parent B First Name *
Provide Name Given to Child at Birth
Last Name *
County *
Date of Birth *
Middle Name
Parent A First Name *
City *
Last Name *
Name of Child's Parents (name given at birth or on birth certificate / Maiden Name)
State *
Middle Name
Describe Change
Last Name *
Middle Name
First Name *
How many copies? *
Where was the Child Born?
New Name
If the Child's Name was changed please indicate:
City *
Middle Name
Spouse B First Name *
County *
Last Name *
Where did the Event take place?
Name of Spouses (name given at birth or on birth certificate / Maiden Name)
Date of Event *
Last Name *
How many copies? *
Middle Name
State *
Spouse A First Name *
County *
Middle Name
State *
Middle Name
Parent A First Name *
First Name *
How many copies? *
Where did the Decedent pass away?
Last Name *
Name of Decedent's Parents (name given at birth or on birth certificate / Maiden Name)
Last Name *
Provide Name of Decedent
Last Name *
Middle Name
Date of Death *
Parent B First Name *
City *