New York Birth Certificate Application (Form DOH-4380) (DOH-4380)
Official state formForm DOH-4380Free downloadLast verified November 9, 2026
Form DOH-4380 is used to request a certified copy of a New York birth certificate for births outside New York City. It is mailed to the New York State Department of Health, Bureau of Vital Records.
Who can use this form
- The person named on the record
- A parent named on the record
- Anyone else, including a spouse or child, only with a New York State court order
What to send with it
- The completed application (Form DOH-4380)
- Proof of identity: a primary photo ID, or two secondary documents showing your name and address
- A notarized signed statement and copy of your driver's license, if the certificate goes to a P.O. box or a third party
- The state fee by check or money order payable to New York State Department of Health
Where to send it
- Mail to
- New York State Department of Health Vital Records Certification Unit P.O. Box 2602 Albany, NY 12220-2602
- State fee
- Not provided
- Typical processing
- Not provided
- Source
- Official government page