The Non-Premium Birth Certificate Application (Form VR 67, printed on the PDF as Application To Request an NYC Birth Certificate) is the mail-in request form of the NYC Department of Health and Mental Hygiene (DOHMH). It is one of the resources for getting an NYC birth certificate, and it serves people born in the Bronx, Brooklyn, Manhattan, Queens or Staten Island, or their parents and legal guardians. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form, its notary page and the mailing address come from the NYC Health Department.
Last updated
What is VR 67?
The Non-Premium Birth Certificate Application, printed as Application To Request an NYC Birth Certificate (Form VR 67), is the NYC Department of Health and Mental Hygiene (DOHMH) form used to request a birth certificate for a person born in the five boroughs, by mail.
The Health Department lists it as the non-premium application: it is for people who want to request a certificate by mail without paying for premium mail service. The Health Department says non-premium requests are processed manually and take longer. The agency publishes a separate Premium Birth Certificate Application, which this page does not cover.
Completing the form produces a request for one to three copies, in one of two types. A short form certificate shows the person's first and last name, place of birth, date of birth, sex at birth, file date and the parents' first and last names, and is used for domestic purposes such as a driver's license or U.S. passport. A long form certificate adds details such as time of birth, hospital name and parents' birthplaces, and is generally used for international purposes such as dual citizenship, international adoption, international marriage and an apostille. The reason you check in Section Three decides which type you receive.
The form has five sections: your name and relationship, the birth certificate information, the reason for the request, a veteran fee waiver, and a notarized signature page. It is not for attorneys, who use the Attorney Protocol for NYC Birth Certificates, and it does not cover births outside the five boroughs.
Who needs to file VR 67?
You use this form if you were born in the five boroughs of New York City (the Bronx, Brooklyn, Manhattan, Queens and Staten Island) and want to request your birth certificate by mail. You must be the person named on the certificate and at least 18 years old, or the parent or legal guardian of that person.
Section One also offers these relationships:
- your own certificate;
- mother or father/parent of the person named;
- legal guardian or custodian, who must provide the original guardianship or custody court order;
- a member of a human services organization associated with a minor child or a developmentally disabled adult.
Do not use this form in these cases:
- You are an attorney requesting for a client. Use the Attorney Protocol for NYC Birth Certificates form at on.nyc.gov/birth-certificate-attorney.
- You are requesting the certificate of a deceased person. The form directs you to the Family Tree/Link to Decedent document at on.nyc.gov/family-tree and the death certificate, and the Health Department also lists a separate application for deceased persons.
- The person was born outside the five boroughs, including Nassau, Suffolk or elsewhere in New York State. The NYC Health Department does not issue those certificates.
Parents of a newborn do not need to apply: the Health Department mails a free certificate about four weeks after birth.
When to file VR 67
File the form whenever you need a certified NYC birth certificate; the form prints no deadline. Choose the reason in Section Three that matches your need, because it decides whether you receive a short or long form certificate.
Veterans born in NYC may receive one free birth certificate when the request relates to Veterans Administration benefits, enlistment or induction in the U.S. armed forces, a veteran's bonus under New York State law, or allowances for dependents of armed forces personnel.
The Health Department says non-premium mail requests are processed manually and take longer than premium ones. For current processing times and order status, the form points to nyc.gov/vitalrecords. Online orders through VitalChek are processed within 72 hours on weekdays. If you have an emergency related to travel, health care coverage, government services, military, housing or employment, the agency page says to call 311 or email [email protected].
Documents you need
- Legible copy of one current (not expired) Category 1 photo ID that is also signed, such as a driver's license, non-driver's ID, passport with a signature, IDNYC or military ID (military ID only for the person whose certificate is requested).
- Without any Category 1 document: two proof of address documents, each dated within the last 60 days and showing your name and address (utility, telephone or medical bill, official government mail, or a rent invoice).
- Original legal guardianship or custody court order, only if you apply as legal guardian or custodian of the person named on the certificate.
- Proof of veteran status from Table 3, such as DD Form 214, DD Form 2 (Retired), a Veteran ID Card or a veteran-designated NYS license or IDNYC, only if you claim the veteran fee waiver.
- For a deceased person's certificate: the Family Tree/Link to Decedent document and the death certificate; a copy if the person died in NYC, a certified death certificate if outside NYC.
- Payment by check or money order payable to NYC Department of Health and Mental Hygiene for the number of copies and any search fee.
How to fill out VR 67
Confirm you can use this form
You must be the person named on the certificate and at least 18, or the parent or legal guardian, and the birth must have been in the five boroughs. Print clearly in English only, in black ink.
Enter your name and address
Section One: write your first, middle and last name as they appear on your ID, your mailing address, apartment number, city, state and ZIP code, phone numbers and email address. Do not use an "in care of" address.
Mark your relationship
In Section One, check whether you are requesting your own certificate, are the mother/parent or father/parent, hold legal guardianship/custody, or belong to a human services organization. If the person died in NYC, write in their death certificate number.
Enter the birth certificate details
Section Two: write the name as it currently appears on the certificate, the date of birth (month/day/year) or a start and end date range, and check Male, Female or X for sex. Add the borough, the mother/parent's maiden name, the father/parent's name and the place of birth if known.
Select the reason and copies
Section Three: check one reason; it decides whether you receive a short or long form certificate. Check One, Two or Three for the number of copies, with a maximum of three.
Complete the veteran fee waiver if eligible
Section Four applies only to U.S. veterans whose request relates to one of the listed reasons. Sign it and include proof of veteran status from Table 3; non-veterans skip it.
Figure the cost of your request
On the cost worksheet, enter the number of certificates, multiply by the per-certificate fee, and add the search fee for each year searched after two if you used a date range. Enter the total amount enclosed.
Sign before a notary
Section Five: sign and date the application as applicant in front of a notary public, who completes the state, county, date, signature and seal. Only this page must be notarized.
Review and download the completed PDF
Check every required field, the name against your ID and the payment total. Download or print the completed PDF from FillingPDF, then assemble the package described under How to submit.
How to submit VR 67
The form is submitted by mail. The NYC Health Department also accepts birth certificate orders online and in person, and does not accept them by email.
- By mail: send the completed and notarized application, a copy of your current photo ID (or the proof of address documents), and payment to: NYC Department of Health and Mental Hygiene, Attention: BC Request, 125 Worth St., Room 119, CN-4, New York, NY 10013.
- Payment: a fee applies for each certificate, plus a search fee if you give a date range instead of an exact date of birth; the amounts are on the form and the cost worksheet. Pay by check or money order payable to NYC Department of Health and Mental Hygiene. Cash and starter checks are not accepted. Applicants outside the U.S. need an international money order issued by a U.S. bank in U.S. dollars.
- Online: for faster processing, order at vitalchek.com. Only the person or parent(s) named on the certificate can order online.
- In person: the Health Department says in-person orders are made by appointment, which you schedule online.
Birth certificates cannot be mailed to addresses labeled "in care of." If you cannot provide the ID in Table 1 or the proof of address in Table 2, call 311 or email [email protected]; from outside NYC call 212-NEW-YORK (212-639-9675). FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Leaving information blank in Sections One and Two; the form says all fields are required and blanks delay the request.
- Mailing the application without notarizing Section Five on page 5, or without your signature and date.
- Sending an expired ID, an unsigned ID, or an unclear photocopy; the ID must be current and signed, and the copy must be clear.
- Giving proof of address documents dated more than 60 days ago, or only one document when no Category 1 ID is provided.
- Writing a mailing address "in care of" someone; certificates cannot be mailed to those addresses.
- Paying with cash or a starter check; only checks and money orders are accepted.
- Choosing a short form reason when you need an apostille; the apostille reason brings the long form and a Letter of Exemplification.
- Ordering more than three copies on one application.
- Claiming the veteran fee waiver in Section Four without proof of veteran status from Table 3.
- Using this form as an attorney, or for a person born outside the five boroughs.
Frequently asked questions
How do I get an NYC birth certificate by mail?
Complete Form VR 67, have page 5 notarized, and mail it with a copy of your current photo ID and a check or money order to the NYC Department of Health and Mental Hygiene, Attention: BC Request, 125 Worth St., Room 119, CN-4, New York, NY 10013.
Who can apply for an NYC birth certificate with this form?
The person named on the certificate if at least 18 years old, or the parent or legal guardian of that person. The birth must have been in the Bronx, Brooklyn, Manhattan, Queens or Staten Island. Attorneys use a different form.
Does the application have to be notarized?
Yes. Section Five on page 5 must be notarized, and you must sign and date it. Only that page needs the notary; you also submit a copy of your current ID with the application.
What is the difference between a short form and a long form NYC birth certificate?
The short form is used for most U.S. purposes, such as a driver's license or passport. The long form adds details like time of birth and parents' birthplaces and is generally used for international purposes. The reason you check in Section Three decides which you get.
What ID do I need to send with Form VR 67?
A legible copy of one current, signed photo ID, such as a driver's license, passport with a signature, IDNYC or military ID. Without one, send two proof of address documents dated within the last 60 days, such as a utility or phone bill.
Is the NYC birth certificate free for veterans?
A veteran born in NYC may get one free certificate when the request relates to VA benefits, enlistment or induction, a NYS veteran's bonus, or allowances for dependents of armed forces personnel. Sign Section Four and include proof from Table 3.
How long does a non-premium NYC birth certificate request take?
The Health Department says non-premium requests are processed manually and take longer than premium ones. Check nyc.gov/vitalrecords for current processing times and order status. Online VitalChek orders are processed within 72 hours on weekdays.
How do I get an apostille on an NYC birth certificate?
Select Apostille as your reason in Section Three to receive a long form certificate with a Letter of Exemplification. The County Clerk's office must notarize the letter, and the New York State Department of State then issues the apostille.
Can I fill out Form VR 67 online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the application or notarize it; you mail it to the Health Department yourself.
Ready to fill out VR 67?
Fill out VR 67 now