Applications and Requests
Please note: Fees are nonrefundable. FEE SCHEDULE (196 KB, pdf)
- Bank Code Removal Form
- Birth Record Search Request
- Death Record Search Request
- Dog License Application
- Freedom of Information Request (FOIL)
- Genealogical Search Form
- Marriage Record Search Request
- Parking Permit Application – Severe Disabilities
- Renew Dog License
- Senior Trip Sign-up Sheet
Dawn Marie Klingner
Phone: (845) 373-8860 ext. 125
Fax: (845) 373-8140
4988 Route 22
Amenia, NY 12501
Monday-Thursday: 9am – 3pm
Closed Fridays & Legal Holidays
Deputy Town Clerk
Phone: (845) 373-8860 x 100
Fax: (845) 373-8140
Deputy Town Clerk
Phone (845) 373-8860 x 101
A Message from the Town Clerk
I would like to tell you a little bit about the Office of the Town Clerk, and about my duties and responsibilities as Amenia’s Town Clerk.
You may not realize it, but the Office of the Town Clerk has served as a direct link between residents and their local government since as far back as biblical times!
As many of you have already experienced, my office prides itself on having a friendly, relaxed atmosphere. We are accessible to the public, answering resident’s questions and taking care of their town-related business needs. For your convenience, I am a Notary Public and offer this service to residents free of charge. Many of the Town Clerk’s duties are mandated by law but many more go well beyond those mandates as the Town Clerk also serves as a major source of information to all residents of Amenia.
My office issues all licenses – for example, hunting & fishing licenses, dog licenses, and marriage licenses, marriage and death transcripts, parking permits, FOIL requests and voter registrations to name just a few. The Town Clerk is also appointed Registrar of Vital Statistics and in this capacity I keep birth, death and marriage records, all of which are issued from my office. I am the custodian of all Town records and am responsible for the storage and disposition of active and inactive records. I am also responsible for keeping minutes of all Town Board meetings, and these minutes serve as the permanent, historic record of the Town. The Town Clerk has many duties related to billing and disbursing funds to the State, County and local fiscal officers and also assists with state and internal audits. These are some of the official duties my office is responsible for, and as you can see, the job is quite a complex one.
I welcome your questions and comments and want you to feel comfortable calling or stopping by my office at the Town Hall with any question you may have, especially if you aren’t sure where to go to get the answer. I can usually get the answer for you or point you in the right direction. You can e-mail me at firstname.lastname@example.org or call the office at (845)373-8860 x125.
Applications for Freedom of Information Request (FOIL); Parking Permits, Genealogical Search, Dog License, Marriage and Death are available for download. Completed applications and fees may be mailed to Town Clerk, 4988 Route 22, Amenia NY 12501
Every dog, regardless of age, owned or harbored in New York State for longer than 30 days must be licensed in the town, city or village where the dog is being harbored. The following are the only license exemptions:
- Dogs under four months – If the dog is under four months of age and not running-at-large (off the owner’s premises)
- Dogs harbored in New York City – Dogs harbored in New York City (these dogs must be licensed by the NYC Department of Health)
- Non-resident dogs – If a non-resident brings a dog into New York State for less than 30 days and the dog is licensed according to the resident state’s licensing laws Dogs confined to a premise – Dogs confined to the premises of any public or private hospital, research institution or a Class A Dealer with a certificate of exemption from the Commissioner.
You may license your dog in person at the Town Clerk’s office or by mail. Licenses are issued for one year.
To be issued an original or a renewal license, you will need to provide:
- spay/neuter certificate if applicable
- proof of current rabies vaccination
- check or cash for the appropriate fee ($12.50 spayed or neutered, $20.50 unspayed or unneutered)
*There is no fee for guide dogs, war dogs, hearing dogs, police work dogs or service dogs*
- Please include a self-addressed, stamped envelope
- Rabies Vaccination Certificate
- Check for the appropriate fee made out to: Town of Amenia
- Bring in your dog’s rabies vaccination certificate
- Bring in cash or check for the appropriate amount
- Hunting and Fishing licenses can be purchased at the Town Clerk’s Office.
- Cash or check, payable to the Town of Amenia.
- Do not heat laminate your license panels as the heat will turn the entire panel pitch black.
- With the new Junior Hunter Mentoring Program, 14 and 15 year olds can now hunt deer and bear with a firearm. Make sure to fill out the required permission form and read the FAQ’s on the DEC Website at www.dec.ny.gov
Birth, Death and Marriage records are available for genealogical search as far back as 1882.The Registrar of Vital Statistics can provide uncertified copies of the following records for genealogy research purposes:
- Birth Certificates – must be on file for at least 75 years and the person whose name on the birth certificate must be known to be deceased.
- Death Certificates – must be on file for at least 50 years.
- Marriage Certificates – must be on file for at least 50 years and the bride and groom are both known to be deceased.
The time periods are waived for direct-line descendants. A direct line descendant is a person in the direct line of descent, i.e., the child, grandchild, great grandchild of the person whose record is requested. The direct-line descendant applicant must provide the following:
- Proof of their relationship to the person whose record they are requesting.
- Proof of the death of the person whose birth certificate they are requesting.
- Proof of the death of the bride and groom whose marriage certificate they are requesting.
- The standard fee for a genealogy copy is $22.00 and applies separately for each record requested. Send the completed form, along with a check for the appropriate amount, made payable to “Town of Amenia”
MARRIAGE LICENSES ARE ISSUED BY APPOINTMENT ONLY
A couple who intends to be married in New York State must apply in person for a Marriage License to any Town or City Clerk in the State. The Marriage can take place anywhere within New York State. Your marriage license is not valid outside of New York State.
The application for a license must be signed by both of the applicants in the presence of the Town or City clerk. No premarital examination or blood test is required to obtain a Marriage License in New York State. There is a 24 hour waiting period during which the ceremony cannot take place.
When both of the applicants are over the age of 16, the 24-hour waiting period may be waived by an order of a Justice of the Supreme Court or a Judge of the County Court of the County in which either party resides.
If either person is under the age of 16, the order must be from the Family Court judge of the County in which the person under 16 years of age resides. A marriage license is valid for 60 days, beginning the day after it is issued.
The expiration date for active duty members of the Armed Forces can be extended to 180 days.
There is a fee of $40.00. Cash or check is accepted. Appointments may be made with the Clerk to apply for a Marriage License after normal business hours.
An original birth certificate, baptismal certificate or a certified copy or transcript with a raised or colored seal is required. It must also be professionally translated if it is not in English. A second form of identification may include any of the following:
•Employment or picture ID
Both of the applicants are required to show proof of any previous divorces. The divorce paperwork must be an original or certified copy and contain the “Judgment of Divorce” section. A certified copy of the death certificate is required when a former spouse is deceased.
Age of Consent
If either applicant is under 14 years of age, a marriage license cannot be issued. If either applicant is 14 or 15 years of age, such applicant(s) must present the written consent of both parents and a justice of the Supreme Court or a judge of the Family Court having jurisdiction over the town or city in which the application is made. If either applicant is 16 or 17 years of age, such applicant(s) must present the written consent of both parents. If both applicants are 18 years of age or older, no consents are required.
One parent alone may consent to a minor’s marriage if: the other parent has been missing for one year preceding the application; the parents are divorced and the consenting parent was given sole custody of the child when the divorce decree was awarded; the other parent has been judged incompetent; or the other parent is deceased.
Parents, guardians or other people consenting to the marriage of a minor must personally appear and acknowledge or execute their consent before the town or city clerk or some other authorized official. If the notarized affidavit is made before an official outside of the State of New York, it must be accompanied by a certificate of authentication when the consent is filed in New York State.
For more information: http://www.health.state.ny.us/vital_records/marriage.html
Copies of Marriage Licenses and Certified Transcripts
The bride, groom, legal representative or anyone who can demonstrate a legal claim can obtain a certified copy. Those requesting the record for a legal claim will not physically possess the record. The record will be sent directly from the Town Clerk’s Office to the agency requiring the record.
If the applicant is not the bride or groom, a judicial or other proper purpose must be documented. An example of a judicial or other proper purpose would be a marriage record needed by the applicant to claim a benefit. Documentation would consist of an official letter from the agency verifying that to process the claim they require from the applicant a copy of the requested marriage record.
Applicants will need to fill out the DOH-301 (Application to Town Clerk for Copy of Marriage Record). Current government issued photo ID is required. Copies are $10.00, and can be paid by cash or check. Checks should be made payable to Town of Amenia. When applying for as copy by mail, the applicant should include a written notarized request along with the application form.
Public Health Law 4101 Charges the local Registrar with the enforcement of complete and accurate vital statistics registration. Therefore, before a home birth is registered, the local registrar must determine when, where and to whom the child was born.
Parents will be asked to provide positive identification, proof of residency, and supporting documentation from a prenatal or postnatal health care provider, the Department of Social Services or other government agency familiar with the family and the mother’s pregnancy. The local registrar may require that the parents and child personally appear at the registrar’s office.
In the case that the mother is not married, the putative father’s name may be entered on the birth certificate only if he and the mother submit a correctly executed Acknowledgement of Paternity (DOH-3732/DSS-4418). In accordance with Public Health Law 4130(2), a Certificate of Live Birth is to be filed with the local Registrar within five days of the date of birth. If more than one year has elapsed since the birth of the child, the registrar will process the birth as a “Delayed Birth”.
Copies of Birth Certificates
A Certified Copy or a Certified Transcript of a birth certificate may be issued only:
- To a person with a New York State Court Order
- To the person named on the birth certificate, if 18 years of age or older
- To the parents of the person named on the birth certificate.
- To the lawful representative of the person named or the parents of the person named on the birth certificate.
- To the Commissioner of Health
- To a municipal, state or federal agency when needed for official purposes.
A Certification of birth may be issued:
- To the person named on the birth certificate; if under 18 years of age
- To a person over 18 years of age, if a certification is what they prefer
- To a person who can demonstrate the record is required for a Judicial or other proper purpose.
To obtain a Certified Copy or Certification, you will need:
- A completed DOH-296A (Application to Local Registrar for Copy of Birth Record)
- Proper government issued photo identification
- $10.00 cash or check, payable to Town of Amenia
- If requested by mail, the applicant should also write a brief request for the copy with a notarized signature.
Copies of Death Certificates
A Certified Copy or a Certified Transcript of a death certificate may be issued:
- To a person with a New York State Court Order issued on a showing of necessity
- To the spouse, parent or child of the deceased
- To the lawful representative of the spouse, parent or child of the deceased
- To a person requiring the record for a documented legal right or claim
- To a person requiring the record for a documented medical need
- To a municipal, state or federal agency when needed for official purposes
Those falling into categories 1, 4 or 5 will not physically possess the record. The record will be sent from the Town Clerk’s Office directly to the agency requiring the record.
To request a search and certified copies:
- Applicant will fill out the DOH-294A (Application to Local Registrar for Copy of Death Record). For records of deaths that occurred after 1/1/1988, the applicant will need to specify whether he or she is requesting the copies with or without the confidential cause of death.
- Applicant will need to provide a current government issued photo ID
- The fee for certified copies of death certificates is $10.00 per copy. Make checks payable to “Town of Amenia”
- If requested by mail, the applicant should also write a brief request for the copy which should be notarized
Handicapped Parking Permit issuing agents are only authorized to issue permits to residents of that agent’s municipality. Applicants will be required to prove identity and residency.
Examples of acceptable proofs of residency are:
- New York State Driver’s License or Non-Driver’s ID card
- Utility Bill
- Property Tax Bill or Receipt
- Letter from Landlord or Residential Care Provider
Any NYS resident that qualifies as a “severely disabled person” is eligible for a statewide parking permit. This includes children and elderly people that don’t drive or own a vehicle. Parents or guardians may apply on behalf of a disabled dependent. A State facility or agency may apply for a permit for each vehicle it uses primarily to transport disabled persons. State agencies must submit the request for a permit on the agency’s letterhead. The request is to include the following:
- Describe the facility or agency
- Explain how it serves individuals with disabilities
- List the plate numbers and year and make of the vehicles in which the permits will be used
- Include a copy of the agency or facility license or authority to operate
Types of Permit
- Temporary Permits are issued to people that have a temporary disability
- The maximum duration for a temporary permit is 6 months. This permit will also be issued to any visitors from another country who are disabled and traveling in New York State.
- Permanent Permits are issued only to applicants diagnosed as a “severely disabled person” and have proper documentation stating such.
- Medical Certification Requirements
Applicants can obtain the standard “Application for a Parking Permit or License Plates, for Persons with Severe Disabilities” form (MV-664.1) from the Clerk’s office or download the application here. The applicant can fill out Part 1. The address should be a physical address, not a P.O. BOX. The doctor needs to fill out Part 2 completely. Part 3 will be filled out by the Town Clerk or Deputy Town Clerk.
Handicapped Parking Permit Renewals
Prior to the expiration of your current permit, you should make arrangements for the renewal of your permit. The procedure for renewing a Handicapped Parking Permit is the same as the procedure followed for the original permit.
An applicant must report lost or stolen permits to the Dutchess Sheriff’s Department (845)486-3800. After receiving a case number, you may come to the Clerk’s office and a new permit will be issued.
Denial or Revocation of Permits
New York State Vehicle and Traffic Law authorizes issuing agents to deny an applicant a permit or to revoke an issued permit if he or she feels there is evidence of abuse. If a permit holder is notified that the permit has been revoked, he or she must return the permit to the issuing agent. If the permit is not returned by the specified date, local law enforcement personnel will be contacted to confiscate the permit.
Visit the New York State Department of Motor Vehicles website at www.nysdmv.com for more information
“Making a false statement, or providing misinformation on an application to obtain or facilitate the receipt of a parking permit or license plates for persons with a disability is subject to fines ranging from $250 to $1,000 under Section 1203-a(4) of the NYS Vehicle and Traffic Law and is punishable as a misdemeanor under Section 210.45 of the NYS Penal Law.”