TO: APPLICANT
FROM: REGISTRAR’S OFFICE
RE: APPLICATION FOR CERTIFICATE OF BIRTH OR DEATH
Please complete the enclosed form in it’s entirety and attach a copy of one of the eight acceptable forms of identification.
Return form and required ID to:
VILLAGE OF MEDINA REGISTRAR
119 PARK AVENUE
MEDINA, NY 14103
Include a money order for $10.00 to cover the cost of the certificate.