Revised 04/2015
TOWN OF ISLIP – ATTN: REGISTRAR’S OFFICE OLGA H. MURRAY
OFFICE OF THE TOWN CLERK TOWN CLERK & REGISTRAR OF VITAL STATISTICS
655 Main St., Islip NY 11751
townclerk@islipny.gov
631-224-5490
Information on How to Obtain a Death Certificate
FEE: ONE (1) COPY $10.00 PER COPY
General Instructions
Use this application if you are the spouse, parent or child, or sibling of the deceased.
Use this application only if the death occurred in the Town of Islip.
Do not use this application for genealogy requests
Print a copy of this application, complete and sign.
Mail application with a money order and a copy of any required documentation or bring in person with cash or money
order and any required documentation (see below).
Identification requirements -Application MUST be submitted with copies of either A or B.
A. One (1) of the following forms of valid photo-ID:
State issued drivers or non-drivers license
Military ID
Passport
B. Two (2) of the following showing the applicant’s name and address:
Utility bills or telephone bills for two consecutive months
C. Applicant’s birth certificate must be provided
What is lawful right or claim?
If the applicant is not the spouse, parent or child (18 years or older), or sibling of the decedent, a lawful right or claim
must be documented. An example of lawful right or claim would be a death record needed by the applicant to claim a
benefit. Documentation would consist of a copy of a court order or an official letter verifying that a copy of the
requested death record is required from the applicant in order to process a claim.
Payment: If no record is on file, a No Record Certification is issued and the fee is not refunded. Mailed requests can only be
obtained by money orders. Completed requests will be returned by first class mail unless a pre-paid return mailer is provided. We
do not accept pre-paid envelopes from UPS. We will accept pre-paid envelopes from Federal Express or the Unites State Post Office
only.
Processing time: Mail requests will take up to two (2) to three (3) weeks once received.
Completing the Application: Once you have completed form, print and sign it. Bring or mail to Town of Islip Registrar Dept., 655
Main St., Islip, NY 11751 along with money order made payable to ‘Town of Islip” and any other required documentation. If you
bring in the application cash is accepted, but do not send cash through the mail.
Attorney copies: Requests must be made on letterhead. Please include all vital information and reason you are requesting same.
Attorney must sign letter and mail a copy of their driver’s license and Office of the Court Administration ID. Payment may be made
with your business check.
