Comments and Questions on a Newborn Birth Certificate

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Birth and Death Certificates Home

Comments and Questions on Ordering a NYC Birth or Death Certificate

Directions: Please enter all the requested information into the available boxes. Once you have completed the appropriate sections, please click on the Submit button on the bottom of the page to send the information to our staff.

Vital Records Comment Form (Required):

Your Name:
Phone Number (Day):
Phone Number (Evening):
E-Mail:
Your Street Address:
City:
State:
Zip Code:

Because we may need to contact you with additional questions, it is important that you leave complete and accurate information regarding your name, address, telephone number, and email address.

If you would like additional information about a pending birth or death certificate order, please fill out the appropriate form.

Birth Certificate Comments

Name on Birth Certificate:
Date of birth:
Mother's maiden name:
Place of birth:
Date requested:
Your relationship to person on certificate:

How was the birth certificate ordered?

online

mail

walk-in

Please check all that apply:

I have not received my own/my child's birth certificate.

I have not received my own/my child's corrected birth certificate

There is some other problem with the certificate I received.

An item on the certificate is incorrect.

I did not receive the correct number of certificates.

You may provide additional information below:

Death Certificate Comments

Click here to submit comments and questions about a birth certificate order.

Name on Death Certificate:
Date of death:
Place of death:
Date requested:
Your relationship to decedent:

How was the death certificate ordered?

online

mail

walk-in

Please check all that apply:

I have not received the death certificate.

There is some other problem with the certificate I received

An item on the certificate is incorrect.

I did not receive the correct number of certificates.

You may provide additional information below:

If the above information is correct, use the Submit button to send comments and questions to the Office of Vital Records. If you need to make a change, hit the Start Over button to erase all of the information entered.

NOTE: You will need to enable JavaScript in your browser in order to submit this form.

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