BIRTH CERTIFICATE APPLICATION
MONROE COUNTY, ROCHESTER, NY - DISTRICT 2700
BIRTH NAME:
DATE OF BIRTH:
MOTHER'S FULL MAIDEN NAME:
FATHER'S NAME:
NUMBER OF COPIES:
** Certified copies are $30 each. (ex. 2 copies = $60) Please send check or money order only. DO NOT MAIL CASH.
PLEASE CHOOSE:
TRANSCRIPT (Recommended for anyone over 18 for security
purposes. Passports, Enhanced License, and Marriage License)
FULL IMAGE (Minors and Dual Citizenship)
APPLICANT INFORMATION
APPLICANT'S NAME:
RELATIONSHIP:
SELF PARENT
POA/GUARDIAN - include copy of judicial court documents
STREET ADDRESS:
CITY, STATE, ZIP:
PHONE NUMBER:
SHIPPING:
USPS First Class Mail - No Charge
USPS Priority Mail Flat Rate - $25.00 additional
UPS Overnight Delivery - $40.00 additional - signature required
In order to process your request you must submit the completed application along with a copy of your photo ID and a check (third
party checks require signee ID) or money order for $30 (per copy requested) plus any additional shipping charges if applicable to:
Monroe County
Vital Records Office
740 East Henrietta Road
Rochester, NY 14623
Attn: Birth Record Request
Incomplete applications will delay your order. If you have any questions about your order, please contact our office at
(585) 753-5141.
* We do not have full images prior to 1928
