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Vital Records Supply Form NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section - Registration Unit Vital Records Supply Form SEND YOUR ORDER TO: MAILING LABEL (Please print or type, Do not use stamp,) Vital Records Section New York State Department of Health Registration Unit P.O. Box 2602 Albany, NY 12220-2602 District No(s). Name Title Mailing Address (Street or PO Box) Date order mailed: (City, Town or Village) Zip Code DOH ORDER #: NAME OF FORM Form No, Quantity NAME OF FORM Form No. Quantity REFERENCE MATERIALS APPLICATION FORMS Vital Records Supply Form DOH-2230 2 Search of Birth Records DOH-296A (Automatically Supplied with Order) Search of Death Records DOH-294A Genealogical Searches DOH-1562 Search of Marriage Records DOH-301 Search of Dissolution of Marriage Records DOH-295 BIRTH FORMS Certificate of Live Birth DOH-1963 MARRIAGE & DISSOLUTION OF MARRIAGE FORMS Marriage License and Affidavit DOH-98 Electronic Birth Certificate Work Booklet (English) DOH-2184E Getting Married in NYS - Information Booklet PAG-4210 Electronic Birth Certificate Work Booklet (Spanish) DOH-2184S AIDS Fact Sheet PAG.{)245 Affidavit for Correction of Marriage DOH-1827 Supplemental Report of Given Name (VS-31) DOH-51 Certificate of Consent DOH-2279 Application for Correction of Certificate of Birth DOH-297 Monthly Report of Marriage Licenses Issued DOH-963 Instructions for the Correction of a Birth Certificate DOH-297i Certificate of Marriage Registration (VS-12) DOH-130 Certification of Birth (VS-10) [8.5 x 11 inch form] DOH-2248a Return Envelope (Limit 24 per year) (VS-7) DOH-2388 No Record Certification - Birth (VS-11) DOH-3656 No Record Certification - MarriaCle (VS-13) DOH-3654 Certification of Birth (Foundling) DOH-2676 Certificate of Dissolution of Marriage (VS-140) DOH-2168 Certified Transcript of Birth DOH-2673 Certified Transcript of Marriage DOH-4122 Report of Voided Certification of Birth Forms DOH-2822 Report of Voided Certified Transcript of Birth Forms DOH-2824 AUTOMATIC TRANSFER BINDERS Birth Information Release Form DOH-3965 Birth - for binding 500 Certificates DOH.{)01 Death - for binding 500 Certificates DOH.{)02 INDEX PAGES DEATH AND FETAL DEATH FORMS Birth - loose leaf pages for binders DOH-2392 Certificate of Death DOH-1961 Death - loose leaf pages for binders DOH-2393 Burial-Transit Permit (VS-61) DOH-1555 MISSING CHILDREN Application for Correction of Certificate of Death DOH-299 Notification of Request for DOH-3895 Instructions for Correcting Death Certificate DOH-299i Missing Child's Birth Certificate MedicallBurial Death Correction Report (VS-64B) DOH-1999 Physical Description Form DOH-3896 Undertaker's Request for Disinter Body (VS-67) DOH-2699 Report of Autopsy (VS-69) DOH-3657 ADOPTION REGISTRY Certification of Death (short form) DOH-2825 Information Packet PAG.{) 1 01 No Record Certification - Death (VS-63) DOH-3405 Aoolication - Adootee Reaistration Form DOH-3D Certificate of Fetal Death - Spontaneous Termination DOH-3547 Application - Birth Parent Registration Form DOH-4065 Certificate of Fetal Death - Induced Termination DOH-3548 Monthly Count of Report of Fetal Death DOH-2179 MISCELLANEOUS Report of Voided Certification of Death Forms DOH-2823 Appointment of Registrar DOH-1556 Certified Transcript of Death DOH-4144 Appointment of Sub-Registrar DOH-2457 DOH-2230 (05/06) Page 1 of 2 Ordering Vital Records Forms Ordering Schedule Registrars and clerks: Refer to the Ordering Schedule to determine the designated ordering point for your district. Mail your orders so they are received at the Department of Health within the designated week for the County where your district is located. Orders received before or after the designated week will be held for processing until the next cycle. Find the county in which your district is located. Send your order so it will be received by the Department of Health during the week of the month specified for that county. NOTE: The First Week of the Month is the week in which the first Monday occurs, the Second Week corresponds to the second Monday, etc. When ordering forms, please: First Week of the month: .I Send one order each month. .I Use the current Vital Records Supply Form, DOH-2230. Albany Allegany Broome Cattaraugus Cayuga Chautauqua Chemung Chenango Clinton Columbia Cortland Delaware Dutchess Erie .I Adhere to the schedule. .I Plan ahead. Don't wait until you are out of forms to place your order. .I Maintain a three-month supply of forms. Over ordering depletes the Health Department's inventory and causes shortages. Second Week of the month: .I Fill out the Vital Records Supply form completely. Essex Franklin Fulton Genesee Greene Hamilton Herkimer Jefferson Lewis Livingston Madison Monroe Montgomery Nassau Niagara Oneida .I Order by mail. Telephone requests will not be accepted. .I Specify the actual number of forms needed. Do not order packages. Third Week of the month: .I Specify "Vital Records Supply Form" in the lower-left corner of your mailing envelope. Onondaga Ontario Orange Orleans Oswego Otsego Putnam Rensselaer Rockland St. Lawrence Saratoga Schenectady Schoharie Schuyler .I Make sure your district number and address are legible. Send your orders to: Fourth Week of the month: New York State Department of Health Vital Records Section/Registration Unit P.O. Box 2602 Albany, NY 12220-2602 Seneca Steuben Suffolk Sullivan Tioga Tompkins Ulster Warren Washington Wayne Westchester Wyoming Yates DOH-2230 (05(06) Page 2 of 2