ZIP
430 Park Avenue
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]} ext 211 or 212
{[AWEBSITE]}
State
{[PNAME]}
Applicant Details
Current Mailing Address (must match address on ID)
City
First Name
Email
Middle Name
Last Name
Phone #
Current Mailing Address
  • Instructions
  • Request
  • Birth
  • Marriage, Civil Union, Domestic Partnership
  • Death
  • Submit

The following must be sent with your application:

  • all required copies of ID for proof of identity.
  • the correct fees.
  • copies of documents proving your relationship to the person named on the record, if requesting a certified copy.

Your application will be returned if you do not send in all required documentation.

Step 1: Identify the Record:

You must be able to fully identify the record by providing all of the information listed below on the application form. Your request cannot be accepted unless you provide the information below.

  • Full name on the record.
  • City where the event occurred.
  • Exact date of the event (month, day and year).
  • Mother’s maiden name.
  • Father’s name (if recorded on the record).
  • For Marriage, Civil Union or Domestic Partnership -- Instead of parents’ names, you must provide the name of the spouse/partner.

Step 2: Provide Acceptable Identification:

You must provide acceptable ID in order to get a copy of any vital record. Copies of vital records must be mailed to the address listed on your identification.

The following are acceptable forms of ID:

  • A current, valid photo driver's license or photo non-driver's license with current address OR
  • A current, valid driver’s license without photo and one alternate form of ID with current address OR
  • Two alternate forms of ID, one of which must have current address.

Alternate forms of ID are:

  • Vehicle registration.
  • Vehicle insurance card.
  • Voter registration.
  • US/Foreign Passport.
  • Immigrant Visa.
  • Permanent Resident Card (Green card).
  • Federal/State ID.
  • County ID.
  • School ID.
  • Bank Statement (within previous 90 days).
  • Utility bill(within the previous 90 days).
  • Tax Return or W-2 for current/previous tax year.

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.

Step 3: Payment of Fees:

The Township of Scotch Plains charges:

  • $10 per certified copy;
  • Certifications are not issued in our office. Please contact the State Department of Vital Statistics and Registry. A certification is an uncertified informational copy of the vital record not valid for establishing identity or legal purposes.

Please do not send cash through the mail. Check or money order ONLY.

Step 4: Proof of Relationship:

To get a certified copy of a person’s vital record, you must provide proof of your relationship to the person listed on the record and the proof must establish you are one of the following:

  • The subject of the record.
  • The subject’s parent, legal guardian or legal representative.
  • The subject’s spouse/civil union partner; child, grandchild or sibling, if of legal age.
  • A state or federal agency for official purposes
  • Pursuant to court order.
Failure to provide proof of relationship is the number one reason certified copy applications must be rejected.

 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.

  • 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,

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 Local Registrar to issue a certified copy of the record. A subpoena is not sufficient to issue a copy of a vital record.

Step 5: Send your completed application, document copies and payment

Please make sure the following is included:

  • all required copies of ID establishing your identity.
  • the correct fee, and
  • copies of documents proving your relationship to the person named on the record, if you are ordering a certified copy.

Your application will be returned if you do not send in all required information.

Instructions
Other (specify)
Veteran's Benefits
Medicare
Request Details
Driver's License
Request for
Passport
Social Security Card/Benefits
Welfare/Disability
School/Sports
What is the purpose of your request (select as many as necessary)
Record Type
Relationship to Person on Record
Birth Details
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
Was the child's name changed?
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
# of 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
# of Copies
Middle Name
State
Marriage, Civil Union, Domestic Partnership Details
Spouse A First Name
County
Middle Name
State
Middle Name
Parent A First Name
First Name
# of Copies
Where did the Decedent pass away?
Last Name
Death Details
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
Type Full Name :
Sign With Hand
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
The amount due is $10.00 for EACH Certified Copy of Marriage, Birth or Death
Certification
Please attach the necessary documents below and any other supporting documents:
  • Proof of Relationship-Per State.
  • Proof of Acceptable Identification.
Amount Due
Applicant Signature