Town Clerk/Forms

Staff Contacts

Sherrie Jacobs

Notary Public | Registrar of Vital Statistics

BINGO & Other Charitable Gaming

Licenses for Bingo and other Charitable Gaming activities must be approved by the Town Board, and then issued by the Town Clerk.

For more information regarding the complete rules and requirements for Charitable Gaming, please see the New York State Racing and Wagering Board ( under the heading Charitable Gaming.

Birth/Marriage/Death Records

Birth Certificates are filed in the municipality in which the person was born, Death Certificates are filed in the municipality in which the person was declared dead, and Marriage Certificates are filed in the municipality in which the Marriage License was purchased. Certified copies of these documents are available at a cost of $10 each, with a completed application and current photo identification required.

A certified Death Certificate can be obtained by the spouse, children, parents, or siblings of the deceased. A certified Birth Certificate can be obtained by the person named on the Birth Certificate, if 18 years of age or older, or by the parents of the person named on the Birth Certificate. A certified copy of a Marriage License can be obtained by the spouses named on the Marriage License. A person with a New York State Court Order or a documented judicial need can also obtain certified copies of these documents. Vital Statistics records are NOT available for perusal by the general public for genealogy or other purposes. Uncertified copies of Birth, Death, and Marriage records can be obtained for genealogical purposes according to the following New York State criteria:

Birth Certificate – The Birth Certificate must have been on file for at least 75 years AND the person named in the Birth Certificate is known by the applicant to be deceased.

Death Certificate – The Death Certificate has been on file for at least 50 years.

Marriage Certificate – The Marriage Certificate has been on file for at least 50 years AND the spouses named in the Marriage Certificate are known by the applicant to be deceased.

Burial Permits are filed in the municipality in which the deceased is buried. Copies of Burial Permits may be obtained by the same persons who would be eligible to receive a certified copy of a Death Certificate.

Copy of Birth Record Application

Copy of Death Record Application

Copy of Marriage Record Application

Dog License

The Town Clerk’s Office acts as the issuing agent for dog licenses in the Town of Conklin. Regulations are covered in both the Agriculture and Markets Law of the State of New York and various Town of Conklin Local Laws.


• When should a dog be licensed? Dogs must be licensed in Conklin when the dog reaches four months of age. Rabies vaccination may be administered after the puppy reaches three months of age. NYS law provides one month to allow the owner to have their animal vaccinated prior to licensing. See Dog Control Page (link to dog control page) for current Rabies Vaccination Clinics

• Where? Application is made at the Town Clerk’s Office. They may be done in person or through the mail. If requested by mail, a self-addressed, stamped envelope must be provided.

• What are the requirements? For a spayed or neutered dog, a certificate signed by a licensed veterinarian showing that the dog has been spayed or neutered, must accompany the application unless the certification is already on file. If submitted by mail, the certificate will be copied for the files and returned to you. Certificate of Rabies vaccination, or a certificate by a licensed veterinarian stating why the life of the dog would be endangered by the vaccine, must accompany application. If submitted by mail, the certificate will be copied for the files and returned to you. In the case of a guide dog, satisfactory proof that the dog is in fact used for that purpose must accompany application.

• What is the cost?

$ 2.50 Spayed Female/Neutered Male
$10.00 Local Fee
* $12.50 Total Due

$ 7.50 Unspayed/Unneutered Male
$ 3.00 NYS Spay/Neuter Fee
$10.00 Local Fee
* $20.50 Total Due.

Late fees for delinquent dog licenses are assessed as follows:

If the license is more than 30 days overdue, a $10 late fee is due in addition to the regular licensing costs.

If the license is more than 60 days overdue, a $20 late fee is due in addition to the regular licensing costs.

• The local fee collected for the dog licenses is used solely for the controlling of dogs and maintenance of the Front Street Animal Shelter.

DOG CONTROL LOCAL LAW: According to the Dog Control Local Law of the Town of Conklin, it is unlawful for any owner of any dog to permit or allow the dog to run at large unless the dog is restrained by an adequate leash or unless it is accompanied by its owner or a responsible person able to control it by command. Any dog found running at large is subject to seizure. For additional information contact the Dog Control Officer at 217-8857 or the Town Clerk at 775-3454.

Application for Dog License

Election Information

Although the Town Clerk oversees the election process in the Town of Conklin, the Broome County Board of Elections conducts all elections and can be reached at 778-2172.

New York State Voter Registration Forms: These forms are available at the Town Clerk’s Office as well as the Board of Elections. Deadline Information: You can register in person at the County Board of Elections on any business day except election day.

If you want to vote in an election, you must mail or deliver the registration form to the Broome County Board of Elections no later than 25 days before the election in which you want to vote. Your eligibility to vote will be based on the date you file the form and the Broome County Board of Elections will notify you of your eligibility. You must meet the following qualifications to register to vote:

  • Be a U.S. citizen
  • Be 18 years old by the year in which you file the registration (Note: You must be 18 years old by the date of the general, primary or other election in which you want to vote.)
  • Live at your present address at least 30 days before an election
  • Not be in jail or on parole for a felony conviction
  • Not claim the right to vote elsewhere Applications for Absentee Ballots are also available at the Town Clerk’s Office as well as the Broome County Board of Elections. Note: You must re-register to vote if you change your name and/or address or if you wish to change your political party since the last time you voted.
Employment Application

If you’re interested in employment in Broome County please fill out the following application:

Freedom Of Information Requests

Freedom of Information (FOIL) requests may be submitted on paper or electronically via e-mail. The Town of Conklin has a FOIL request form, but it is not required that an applicant use this form.

The Town has five business days after a request is received to either approve or deny the request, with the reason for denial if that is the case, and twenty business days in which to gather the information requested and make it available to the applicant. If the FOIL request is excessively large or complex, it may take longer than the twenty days and this will be explained to the applicant.

Freedom Of Information Requests

Handicapped Parking Information

Handicapped Parking Permits are issued for a six-month period (Temporary – red hangtag) or a three-year period (Permanent – blue hangtag).

Instructions for Completion of Application

Read instructions and then print form.

Legibility and Completeness:

The Parking Permit Application form has three parts:

Part I – To be completed by the applicant.

Part II  – To be completed and signed by the certifying physician.

Part III – “For Official use only”.

It is the applicant’s responsibility to ensure that Parts I and II are complete and legible. Incomplete or illegible applications will be returned without approval. You must provide your Driver’s License in order to receive a Parking Permit. If you do not have a Driver’s or Non-Driver’s license, contact the Town Clerk’s Office at 775-3454 for further information.

Filing of Application:

Completed applications may be brought to the Town Clerk’s Office at 1271 Conklin Road, Conklin, NY.

Application for Parking Permit or License Plates for Persons with Severe Disabilities

Marriage Licenses

Marriage Licenses may be obtained from any New York State municipal clerk and the couple obtaining the Marriage License may be married at any location in New York State. In order to obtain a Marriage License, the couple must provide a birth certificate for each, divorce papers or death certificate(s), if applicable, for each preceding marriage, if it is not a first marriage, and current photo identification.

Both parties must sign the Marriage License in the presence of the Town Clerk. The cost of a Marriage License is $40, which in the Town of Conklin must be check or cash. Please call the Conklin Town Clerk at 775-3454 to request an application for a marriage license and to set up an appointment to come with your documentation and to sign your license before the Town Clerk. Town Justice Beth Marshall is available to perform civil marriage ceremonies and may be contacted through the Court Clerk’s (link to court clerk page)office at 775-5244.

Marriage License Application

Park Permits

For more information about Town Of Conklin Parks visit our Parks Page (link to parks page)


Schnurbusch Park (3) Pavilions

Conklin Forks Park (1) Pavilion

Reservations are required for use of park pavilions by all groups. To obtain a permit, an applicant should call the Town Clerk’s Office to check on availability. Once an available date has been established and the Town Clerk has taken the applicant’s name, the applicant must apply in person at the Town Clerk’s office and pay the required deposit. (No reservations by telephone)

Pavilions in Schnurbusch Park all have water, electricity, and grills available for use.  The pavilion in Conklin Forks Park does NOT have water, but has electricity and a grill.

Permit fees shall be as follows:

Conklin Residents: (Driver’s license required as proof of residency) – $50.00

All Non-Residents – $150

Town of Conklin Not-For-Profits – $30

All Other Not-For-Profits – $60

Note: FUTURE PERMITS WILL BE DENIED if pavilions are not left in good condition with no litter or damage. Picnic tables must be returned to the pavilion(s) before leaving the park.

With each permit issued, the applicant will receive a listing of activities prohibited in the park which include:

a. Parking a motor vehicle in other than designated locations.

b. Operating a motor vehicle in excess of five (5) miles per hour or in any manner contrary to posted regulations.

c. Operating a motor vehicle on other than the designated roads.

d. Allowing dogs to run unleashed.

e. Sports in other than locations designated by the Youth Advisory Board of the Town of Conklin.

f. Entering or using the parks during other than the designated hours posted by the Town Board of the Town of Conklin.

g. Operating or parking a motorcycle, mini-bike or other form of recreational motor vehicle except on designated roads.

h. Over-night parking of motor vehicles.

j. The use of any alcoholic beverage in any town parks.

k. The use of or being under the influence of any illegal drug or substance in any town park.

l. Possess or use firearms, bow and arrow or other dangerous weapons with the park, unless authorized by law or the Town Board.

m. Disturb the peace and good order in the parks by fighting or arguing in loud voices or threaten violence to any person or the property of others.

n. Beg, hawk, peddle or solicit within the parks except as authorized by the Town Board.

o. Use profane or abusive language while in the parks.

p. Injure, deface, destroy, disturb, or remove any part of the parks.

q. Loiter in or near park restroom buildings.

r. Litter or leave behind refuse and garbage except in receptacles provided for such purpose.

s. Start a fire in a park except in park grilles, fireplaces or designated areas.

t. Fail to extinguish before leaving the park all fires started or used. The dumping of ashes or fire onto the ground is absolutely prohibited.

u. Making noise of a type and volume that a reasonable person would not tolerate under the circumstance, which noise causes public annoyance.

v. Use of parking in handicapped viewing area by any person who is not an individual(s) with a disability.

w. Use of facilities, including pavilions, for political activities, except for the following:

x. During the Town Fair candidates for political office may interface (ie, converse, shake hands, etc) with attendees. During the Town Fair political parties may rent a booth from the Fair Committee and sell food, non-alcoholic beverages or products and distribute voter registration materials.

Town of Conklin parks are normally open from 7:00 AM to 8:00 PM

Peddlers & Solicitors License

A Peddler or Solicitor License may be obtained through the office of the Town Clerk. The fee is $100. A detailed application form must be completed and the application must be approved by the Town Board. The Town of Conklin strongly DISCOURAGES door-to-door sales.

Peddlers & Solicitors License


Contact Information

Hours of Operation

Monday – Friday:
9:00 am to 4:00 pm

Marriage Licenses
Appointment only



(607) 775-1434 


1271 Conklin Road
P.O. Box 182
Conklin, New York 13748
See map: Google Maps

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