Forms and Applications On-line

In order to better serve the general public, a number of forms and applications are now available on line. In order to read and print the forms, you will need the free copy of Acrobat reader with your browser. Click on the Acrobat icon to download a free copy.

Disclaimer: The documents posted here are for informational purposes only. Though every effort is made to ensure that they are up to date, you should also contact the proper department to ensure that they are current. Some departments may accept the documents as presented here, but others may require that you pick up a form directly from them. Please be advised that some of these files are quite large and will take some time to download if you do not have a broadband connection.

The fee for recording the First Page of any document will INCREASE from $43.00 to $53.00.
The fee for all additional pages per document will remain at $5.00 per page.

This is mandated statewide.


Land Records
First Page of any Land Record Document - $53.00
Additional Pages in the same Land Record Document - $5.00 per page
State Residential Conveyance Tax Rate - .75%
State Non-Residential Conveyance Tax Rate – 1.25%
Local Conveyance Tax Rate - .25%
Filing Fee for Maps - $10.00
Copies of Land Records - $1.00 per page
Hand-held Scanner Usage - $20.00
Certification of Land Record or Map Copies - $2.00 per certification

Vital Statistics
Birth Certificate Certified Copy (short form) - $15.00
Birth Certificate Certified Copy (long form) - $20.00

Marriage License required to get married - $30.00
Marriage Certificate Certified Copy - $20.00

Death Certificate Certified Copy - $20.00
Burial Permit - $3.00
Cremation Permit - $3.00

Notary Public Service
Fee for Notary Public Service - $5.00 per notarized document

Fee for the Notary
Filing Notary Certificate Commission - $10.00
Replacement Certificate Filing for a Notary - $15.00
Authentication of Signature of a Notary Public - $2.00

Annual Dog Licenses
Neutered Male or Spayed Female - $8.00
Non Neutered or Non Spayed Male or Female - $19.00
Late Fee - $1.00 per month for all late monthes.
Kennel License - $50.00 for 10 tags.
Guide Dogs – Free

Local Political Campaign Finance Reports
Late Filing Penalty - $200.00

These fees are established by the State of Connecticut not the individual municipalities.


Birth certificates are confidential and only those persons whose name appears on the certificate (mother, father or person themselves – over the age of eighteen) are entitled to receive copies with the proper identification.

Grandparents can also obtain copies with the proper identification and proof of relationship (if you are a paternal grandparent your son’s name must be on the certificate in order to obtain a copy).

Legal court appointed guardians must provide original papers stating so.

Step parents are not allowed to obtain records.

Legal court order for a change of name can be obtained from the Probate Court in the town which you reside, once the order is granted you must bring the originals to the Town Clerk Office where the birth occurred so that the record can be amended.

When coming into the office you must present a photo ID (Driver License or Passport) or two other forms as stated on the application.

When writing in for a Birth Certificate, you give your name at the time of your birth, date of birth, Mother’s maiden name and father’s name. Enclose the appropriate fees. Again if you do not have photo identification, you must give other forms of identification. Requests will not be filled without the proper identification and the proper enclosed fee.

Birth Certificate Fees:

The fee for a Long Form (Large) Birth Certificate (Needed to obtain Driver’s License, Passport and all other uses) is $20.00.

The fee for a Short Form (Wallet Size) Birth Certificate is $15.00. (It is not recommended to purchase this form as it will not satisfy most requirements of those entities requesting a copy).

Birth Certificate Payments:

When appearing in person at the Town Clerk’s Office, please note that CASH ONLY is accepted for Certified Copies of Birth Certificates.

When applying by mail for a Certified copy of a Birth Certificate, please note that a Money Order Only made payable to the City of Derby is accepted.

DepartmentDocuments Available
Building Inspector
(203) 736-1481

Application for Building Permit
Application for small repairs
Application to demolish.
Application for commercial construction.
Application for electrical work.
Application for heating and fuel equipment.
Application for a generator permit
Application for plumbing.
Application for a roofing permit
Application for a sign permit.
Application for a flammable tank installation

Community Development
Revolving Loan Program Application
Housing Department
Elderly Housing Application
Parks & Recreation
(203) 735-4222
Derby Veterans Community Center Membership Application
Police Department
(203) 735-7811
Forms can be found here
Tax Collector
Transfer of Property Notification

Information on state tax relief programs

Town Clerk
Application for copy of birth certificate
Application for copy of marriage certificate
Application for copy of death certificate
Voter Registration certificate
Trade Name Certificate
Real Estate Conveyance

For information on State of Connecticut forms on line, click here.

Back to Derby Home page                                                                                 winner_logo.jpg (15821 bytes)