Individual Record Request Form

To request an individual record, fill in the form below, being sure to complete all the required fields as indicated by a red asterisk (*). Print the form using the Print button at the bottom of the form or your browser's print button. Mail the completed form along with payment to the address listed below.

The cost for the individual record request is $15. Checks or money orders must be made payable to Westchester County Archives. Unfortunately, we are not able to accept payment by credit card.

Important: Payment must be received before we begin working on your request.

Send the printed request form and payment to:

Archives Reference Desk
Westchester County Archives
2199 Saw Mill River Road
Elmsford, NY 10523

First Name:*  
Last Name:*  

Mailing Address:

ZIP Code:*  

Daytime Phone (include area code):*  
E-mail Address:  

Information about record to be recieved:
Archives Number (usually begins with "A-") or Marriage Certificate Number:*  
Year of Record (if known):  
Last Name:*  
First Name:*  
Middle Name or Initial:  

Other Information or Comments:

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