TOWN OF GLENVILLE
Birth Certificates
To obtain your own or your child’s birth certificate:
Town Clerk Office Hours:
Monday – Friday, 9:00 AM – 5:00 PM
(July and August, clerk’s office closes at 4:00 PM)
IN PERSON
You must have IDENTIFICATION: Drivers License, Passport or Dept. of Motor Vehicle Non-Driver ID only
Fee: $10.00 (personal checks not accepted)
BY MAIL
Fill out application below and mail along with a copy of your identification and a $10.00 money order (no personal checks) made payable to Town Clerk, 18 Glenridge Road, Glenville, NY 12302. Please enclose a self addressed, stamped envelope.
SEE APPLICATION BELOW:
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TOWN OF GLENVILLE
APPLICATION FOR BIRTH CERTIFICATE
For those persons born in the Town of Glenville
Date___________________________________
Certificate Holder's Full Given Name at Birth:
_________________________________________________________________
Date of Birth _____________________________________________________
Full Name of Father _______________________________________________
Full Maiden Name of Mother________________________________________
Purpose for which certificate is required (circle one):
Passport/Travel
Employment
Social Security
Social Services
Other ______________________________________________________________
Your relationship to birth certificate holder: ____________________________
*Birth Certificates are only available to certificate holder, their mother, or father
Your Signature ___________________________________________________
Mailing Address __________________________________________________________
**If Mailing Address is a PO Box, we REQUIRE a Street Address**
Street Address (if different)
______________________________________________________________________
Fee: ~$10.00 cash or money order only (no personal checks)
If applying by mail, please enclose a copy of your driver's license and a self addressed, stamped envelope and send to: ~~
Glenville Town Clerk, ~18 Glenridge Road, Glenville, NY 12302.
(518) 688-1200, ext. 402
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