Sheet 2 of 7
All legal guardians must sign
The guardians of the person whose name is to be changed should give all the information requested on this form about
themselves and about that person.
The child’s father and mother are usually joint
The father and the mother of a child are guardians jointly
of the child unless the child’s mother is the sole guardian
of the child. If the child is legally adopted (by opposite-sex
or same-sex parents) those parents are guardians of the
Father as guardian
The father is usually a guardian of the child if the father’s
particulars were added to the child’s birth information on
or after 1 July 2005 but no later than 24 January 2009.
The mother is the sole guardian
When a child is conceived on or after 1 July 2005, the
child’s mother is the sole guardian of the child if the
mother was not:
• Married to, nor in a civil union with, the father of the child
at any time during the period beginning with the
conception of the child and ending with the birth of the
child; and not
• Living with the father of the child as a de facto partner at
any time during that period.
If the child is born as a result of an assisted reproduction
procedure (such as donor insemination) to a mother
acting alone, and the donor is not the mother’s partner
(i.e. not in a marriage, civil union or de facto relationship),
and the donor does not become the mother’s partner
between conception and notification of the birth for
registration, then the mother is the sole guardian.
Appointment of 1 or more additional guardians
• A testamentary guardian of the child appointed by the
deceased parent under section 26(2) of the Care of
Children Act 2004 or section 7(2) of the Guardianship
• All Court appointed/approved guardians. A certified copy
of the Court appointment as a guardian should be
attached to this declaration.
A guardian may act alone
• In some circumstances a guardian may act alone if the
other guardian(s) is/are dead, unknown, missing (note
that a guardian is not missing if others know of their
whereabouts but they refuse to tell you), of unsound
mind or unable to act because of a medical condition; or
• If Family Court approval is obtained. Appropriate
evidence must be attached to this declaration (note that
this is not a Parenting or Protection order).
If the child was born as a result of an assisted human
reproduction procedure (such as artificial insemination),
and the mother was living in a marriage, civil union or de
facto relationship with a man or a woman who had
consented to her undergoing the procedure, and the
man’s or woman’s name is recorded on the child’s birth
registration, then that man or woman must also sign this
The information provided on this form is collected under the Births, Deaths, Marriages, and Relationships Registration Act 1995
(the “BDMRR Act). A person who makes, or causes to be made, a false declaration on this form will be liable on conviction to a
fine or term of imprisonment, or both. The information will be held on a public register, and may generally be accessed by any
person on application (e.g. as a certificate or printout). The Births, Deaths, Marriages, Citizenship, Authentications and
Translations office may also release it to certain government agencies and foreign registration authorities, as authorised by law.
The BDMRR Act governs access to registered information. Information about your rights to access and, where appropriate, correct
the information is available on our website www.govt.nz/bdm or Freephone 0800 22 52 52.
Births, Deaths, Marriages, Citizenship, Authentications and Translations:
• Website www.govt.nz/bdm
• Freephone 0800 22 52 52 (New Zealand only). If overseas phone + 64
9 339 0852