Fillable Apply For Birth Certificate (New South Wales)

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Apply For Birth Certificate (New South Wales)

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Country of origin: AUSTRALIA
File type: PDF

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Birth Certicate
Application
Applying for a birth certicate
A standard birth certicate is an ocial certied copy of the
registration data held by the Registry, and is commonly used to help
establish a person’s identity.
This application form is for a birth that occurred in, or was registered in
NSW. If you are the person named on the certicate, or a parent of the
person named on the certicate, the birth certicate can be issued to you.
If you DO meet the above criteria, you must provide:
• Three types of your own ID (see below).
If you DON’T meet the above criteria, you must provide:
• A “ Letter of Authority giving permission to apply” available
on our website: www.nsw.gov.au/bdm
• T hree types of ID from the person giving permission (see below).
• T hree types of your own ID (see below).
Your Right to Privacy
When you apply, you consent to the release of information provided,
to those agencies who may be able to validate it.
Please read Your Right to Privacy Policy at www.nsw.gov.au/bdm
Identication (ID)
Please provide at least three types of ID, one of each from categories
1, 2 and 3. If you are unable to provide ID from categories 1 and 2,
you must still provide at least three types of ID. At least two of these
must be from category 3. All documents except foreign passports
must be current.
Category 1 Category 3
If born in Australia:
• An Australian birth certicate
Record of immigration
status:
• Citizenship certicate
• New Zealand citizenship
certicate
• New Zealand birth certicate
• Medicare card
• Credit or debit card
• Centrelink or Department of
Veterans Aairs card
• Security guard/Crowd control
licence
• Tertiary education institution
ID card
Category 2 Category 4
• Australian driver’s licence
• Australian passport
• Firearms licence
• Foreign passport
• Proof of age card
• Recent utility account with
current residential address
(issued within last three
months)
If your name has changed you may be asked to show proof
(e.g. marriage certificate, change of name certificate or deed poll).
Issued by the Registry of Births Deaths and Marriages, New South Wales, Australia.
This Commerative certificate does not contain security features and organisations
may not accept it as a proof of identity document.
Date of issue: 21 March 2018
I hereby certify that this is a true copy of particulars
in a Register in the State of New South Wales, in the
Commonwealth of Australia.
Sex:
Male
Amit Citizen
Date of Birth:
16 March 2018
Place of Birth:
Armidale
My Parents
Given Name
(
s
)
: Dawn
Surname: Citizen
Place of Birth: Chippendale, NSW
My Parents
Given Name
(
s
)
: David
Surname: Citizen
Place of Birth: Chippendale, NSW
Issued by the Registry of Births Deaths & Marriages, New South Wales, Australia. This Commemorative certificate does not contain security features and organisations may not accept it as a proof of identity document.
The Registry does not warrant the accuracy of information relating to club membership details.
MEMBER NO. 614511 – JOIN ED 1995
Date of Issue: Date of Iss ue
I hereby certi fy that this is a true copy of pa rticulars
in the Register in th e State of New South Wales,
in the Commonweal th of Australia.
Registry of Bir ths Deaths & Marria ges NSW
Female
Sex
Jennifer Edwina Lenna Citizen
01 December 2015
Date of Birth
New Lambton Heights
Place of Birth
Parents:
Judith Amber Rose
Given Names
Citizen
Surname
Blacktown
Place of Birth
Alex Lee
Given Names
Citizen
Surname
New Lambton Heights
Place of Birth
Form 7 06/2020
YOU CAN
COMPLETE THIS
APPLICATION
ONLINE AT:
nsw.gov.au/bdm
© ABD Ltd/Ent. One UK Ltd 2003.
BIRTH CERTIFICATE
Date of birth:
Sex:
PARENTS
Given names:
Surname:
Place of birth:
Place of birth:
Given names:
Surname:
Place of birth:
NSW Registry of Births Deaths & Marriages
Date of issue:
Issued by the Registry of Births Deaths & Marriages, New South Wales, Australia.
This Commemorative certificate does not contain security features and organisations
may not accept it as a proof of identity document.
I hereby certify that this is a true copy
of particulars recorded in the Register
in the State of New South Wales, in the
Commonwealth of Australia.
29 June 2015
Male
Lillian Maureen
Done
Salisbury, Wiltshire, England
Siesta Private Hospital, Croydon Park
Cliord Wade
Done
Wolverhampton, Staordshire, England
29 June 2015
Jonathan Robert Smith
Online
You can complete this online at www.nsw.gov.au/bdm
Lodging by post
GPO Box 30
SYDNEY NSW 2001
Lodging in person
Service NSW service centres
service.nsw.gov.au
Phone: 13 77 88
• Monday to Friday (7am-7pm)
Hearing/Speech impaired, phone:
• TTY 133 677
• NRS 1300 555 727
Translating and Interpreting, phone:
• TIS National 131 450
Send information to a Passports oce
Select this option to send your certicate if you have made
prior arrangements with the Australian Passport oce, consulate
or embassy. This only applies to standard certicates, not
commemoratives. Fee applies, see www.nsw.gov.au/bdm
Commemorative birth certicates
Did you know? You can buy a Commemorative on its own, and it
makes an ideal gift perfect for framing!
Commemorative certicates do not contain security features and
organisations may not accept them as proof of identity documents.
Registry of Births Deaths and Marriages NSW
Proudly supporting
Issued by the Registry of Births, Deaths and Marriages,
New South Wales, Australia. This Commemorative certificate
does not contain security features and organisations
may not accept it as a proof of identity document.
Hunter Wren Citizen
Date of birth: 1 July 2016
Sex: Female
Parents
Given names: Dawn
Surname: Citizen
Place of birth: Chippendale, NSW
Given names: Dawn
Surname: Citizen
Place of birth: Chippendale, NSW
Place of birth: Armidale
Date of issue: 1 August 2016
I hereby certify that this is a true copy of particulars recorded in a Register in the
State of New South Wales, in the Commonwealth of Australia.
© The Northcott Society and Cerebral Palsy Alliance 2016
10 0
C
e
l
e
b
r
a
t
i
n
g
YEARS
1918
-
2018
Proudly supporting
Issued by the Registry of Births Deaths and
Marriages, New South Wales, Australia.
This Commemorative certificate does not
contain security features and organisations may
not accept it as a proof of identity document.
© The Northcott Society and Cerebral Palsy Alliance 2017
Registry of Births Deaths and Marriages NSW
Date of birth:
Place of birth:
Sex:
Parent
Given names:
Surname:
Place of birth:
Date of issue:
I hereby certify that this is a true copy of particulars recorded in a Register in the
State of New South Wales, in the Commonwealth of Australia.
Proudly supporting
Issued by the Registry of Births Deaths and
Marriages, New South Wales, Australia.
This Commemorative certificate does not
contain security features and organisations may
not accept it as a proof of identity document.
© The Northcott Society and Cerebral Palsy Alliance 2017
Registry of Births Deaths and Marriages NSW
Snugglepot & Cuddlepie
November 1918
Neutral Bay, NSW
Two little boys
Cecilia May
Gibbs
Sydenham, Kent, England
November 2018
I hereby certify that this is a true copy of particulars recorded in a Register in the
State of New South Wales, in the Commonwealth of Australia.
Proudly supporting
Issued by the Registry of Births, Deaths and Marriages,
New South Wales, Australia. This Commemorative certificate
does not contain security features and organisations
may not accept it as a proof of identity document.
© The Northcott Society and Cerebral Palsy Alliance 2016
Hunter Wren Citizen
Date of birth: 1 July 2016
Place of birth: Armidale
Sex: Female
Parents
Given names: Dawn
Surname: Citizen
Place of birth: Chippendale, NSW
Given names: Dawn
Surname: Citizen
Place of birth: Chippendale, NSW
Date of issue: 1 August 2016
I hereby certify that this is a true copy of particulars
recorded in a Register in the State of New South Wales,
in the Commonwealth of Australia.
Registry of Births Deaths and Marriages NSW
Issued by the Registry of Births Deaths and Marriages, New South Wales, Australia. This Commemorative certificate does not contain security features and organisations may not accept it as a proof of identity document.
Date of issue: 01 January 2013
I hereby certify that this is a tru e copy of particulars
in the Register in the State of New South Wales,
in the Commonwealth of Australia.
Registry of Births Deaths and Mar riages NSW
Hunter Wren Citizen
Date of Birth:
1 July 2016
Sex:
Female
Parents
Given Name(s):
Dawn
Surname:
Citizen
Place of Birth:
Chippendale, NSW
Given Name(s):
David
Surname:
Citizen
Place of Birth:
Chippendale, NSW
Place of Birth:
Armidale
Issued by the Registry of Births Deaths & Marriages, New South Wales, Australia. This Commemorative certificate does not contain security features and organisations may not accept it as a proof of identity document.
The Registry does not warrant the accuracy of information relating to club membership details.
MEMBER NO. 614511 – JOINED 1995
Date of Issue: Date of Issue
I hereby certify that this is a true copy of par ticulars
in the Register in the State of New South Wales,
in the Commonwealth of Australia.
Registry of Births Deaths & Marriages NS W
Female
Sex
Jennifer Edwina Lenna Citizen
01 December 2015
Date of Birth
New Lambton Heights
Place of Birth
Parents:
Judith Amber Rose
Given Names
Citizen
Surname
Blacktown
Place of Birth
Alex Lee
Given Names
Citizen
Surname
New Lambton Heights
Place of Birth
I hereby certify that this is a true copy or particulars recorded in a
Register in the State of New South Wales, in the Commonwealth of Australia.
Date of issue: 3 August 2017
Issued by the Registry of Births Deaths and Marriages,
New South Wales, Australia.This Commemorative certificate
does not contain security features and organisations may
not accept it as proof or identity document.
Registry of Births Deaths and Marriages NSW
Birth Certificate
Female
Hazel Nicola Lewis
05 April 2016
Date of Birth
St George Private Hospital, Kogarah
Place of Birth
Parents:
Sonia Anna
Given Names
Lewis
Surname
Blacktown, NSW
Place of Birth
Luke Steven
Given Names
Lewis
Surname
Blacktown, NSW
Place of Birth
Date of birth:
Sex:
PARENTS
Given names:
Surname:
Place of birth:
Place of birth:
Given names:
Surname:
Place of birth:
I hereby certify that this is a true copy or particulars recorded in a
Register in the State of New South Wales, in the Commonwealth of Australia.
Date of issue:
Issued by the Registry of Births Deaths and Marriages, New South Wales, Australia.
This Commemorative certificate does not contain security features and organisations may
not accept it as proof or identity document.
Registry of Births Deaths and Marriages NSW
29 June 2017
Female
Samantha
O’Brian
Sydney, NSW
Sarah Name Wilson
Sydney, NSW
Tom
Wilson
Sydney, NSW
I hereby certify that this is a true copy or particulars recorded in a
Register in the State of New South Wales, in the Commonwealth of Australia.
Date of issue: 3 August 2017
Issued by the Registry of Births Deaths and Marriages, New South Wales, Australia.
This Commemorative certificate does not contain security features and organisations may
not accept it as proof or identity document.
Registry of Births Deaths and Marriages NSW
ABN 81 913 830 179
GPO Box 30 Sydney NSW 2001 Tel: 13 77 88
Birth Certicate Application
PAYMENT DETAILS (complete this section for mail applications only). Please refer to www.nsw.gov.au/bdm for fees.
Total Amount $
.
Please debit my: AMEX
Mastercard
Visa OR Enclosed is a cheque*/money order
Card number
* Make cheques payable to NSW Department
of Customer Service (non Priority only)
Name
Expiry date
mm / yy
of cardholder
Signature
of cardholder
✗
A surcharge applies to credit card payments at the
rate of 1.4% for AMEX and 0.4% for Mastercard or Visa.
APPLICANT’S DETAILS (person completing this form). Please provide copies of three forms of current identication with your application.
Family name
First given name
Other given name/s
Company name
Company reference number
(If applicable)
(If applicable)
Current address
Suburb/Town
State/Territory
Postcode
Country
Postal address
Suburb/Town
(if dierent from above)
State/Territory
Postcode
Country
Phone number
Email International Registered Post
Signature
of applicant
✗
I certify that I understand the provisions overpage
on Identication, Privacy & Disclosure and that
the information I have provided is true and correct.
DETAILS OF BIRTH CERTIFICATE REQUIRED (This person must have been born or adopted in NSW)
Date of birth*
dd / mm / yyyy
Present age
Registration number
/
(If known)
*If date unknown, period to be searched:
From
dd / mm / yyyy
To
dd / mm / yyyy
(Note: Each extra 10 year search or part thereof incurs a cost)
Names of registered person
Family name Family name at birth
First given name Other given name/s
Place of birth
(Suburb/Town/City)
Parent 1 details
Family name
Family name at birth
(Current)
First given name Other given name/s
Parent 2 details
Family name Family name at birth
(Current)
First given name Other given name/s
What quantity of certicate/s do you require?
Standard birth certicate/s
(enter number) For NRL certicates you can add your Club membership number and year you joined the Club.
Commemorative certicate/s (enter number) Enter description
e.g. 1 Fauna and 1 NRL Sharks (Member 123456 joined 1988) Commemorative
Reason certicate is required
Your relationship to the registered person
(e.g. passport, school) (e.g. self, parent, child)
PRINT clearly in BLACK pen and complete all details.
Do you require Priority processing* of your application? Yes
Do you require copy of the certicate* sent to an Australian passport oce/DFAT oce? Yes
Passport/DFAT oce name and the location:
You must have already made arrangements with the Passport/DFAT oce
* Priority processing and Passport options are only for standard
certifcates and not commemorative. See website for fees.
Form 7 06/2020
YOU CAN COMPLETE THIS APPLICATION ONLINE AT: www.nsw.gov.au/bdm
1
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Apply For Birth Certificate (New South Wales)

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Completed 5 January 2022

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