Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 1 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
General information
Eligibility
To apply to register your relationship in NSW
both partners must be:
over 18 years of age;
not married to each other or anyone else;
not already in a registered relationship
under this Act or in another state or
territory in Australia;
not in a relationship with another person;
not related by family.
At least one partner must reside in NSW.
Neither partner is required to be a (temporary
or permanent) resident of Australia.
The 28-day cooling off period
Once your application has been checked and
everything is complete and correct, it can be
processed.
There is
a cooling off period before the
relationship is registered and a certificate
issued.
To cancel your application to register a
relationship, you can lodge a Notice to
withdraw as long as the relationship is not
registered (page 11).
Only the partners applying to register their
relationship can apply to withdraw.
One or both partners may apply.
There is no fee to withdraw, however the
relationship registration fee is non-
refundable.
Partner(s) who lodge a notice to withdraw
must provide three forms of identification.
Identification documents
Three forms of identity are required for each
partner.
One partner must also show proof of
residency in NSW.
All documents must be in English
(provide accredited translation if necessary).
Applying by post
An authorised witness must certify each
photocopy to say it is a true copy of the
original document.
Applying in person
Original identification is required, if you are
applying in person.
Authorised witness
The following authorised witnesses can certify
identity documents and witness the signing of a
statutory declaration:
Justice of the Peace (JP).
Find a JP at: www.jp.nsw.gov.au
Public Notary
Legal practitioner Solicitor/Barrister (holding
a current Australian practising certificate)
British or Australian Consular Officer;
Judge or Magistrate.
Statutory Declarations
An authorised witness must confirm your
identity before the declaration is made.
They will need an identity document from you
such as an Australian passport, Australian
birth certificate, or driver licence, etc.
A statutory declaration must be completed by
each partner.
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 2 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Your right to
privacy
Privacy
The information required on this form is
collected under the Relationship Register
Act 2010 and the BDMR Act 1995. The
relationship register is part of the civil
records of NSW and a permanent
historical record. The public do not have
access to these records.
Information held by the Registry may be
used for statistical purposes and by law
enforcement agencies, as well as other
uses provided for by law. Such access for
approved purposes may be granted to
other Registries and certain government
and authorised non-government
agencies.
The Registry requires proof of your
identity to protect your privacy. We collect
this information in line with the Privacy
and Personal Information Protection Act
1998, to determine your eligibility to
register a relationship, to issue the related
certificate and to prevent fraud. All
documents are scanned and retained in
the Registry’s system and all copies are
destroyed.
Disclosure of information
When you complete this application form,
understand that you have consented to
the release of information provided by
you, to those agencies which may be able
to validate that information in support of
your application. It is extremely important
that all your identity documents are
accurate and reflect your correct identity
information.
Documents provided as proof of identity
may have their authenticity verified
through the online National Document
Verification Service (DVS).
For more information, please see our
policy on the website: Your Right to
Privacy
Quick Checklist
Before you lodge, check everything is right.
To apply to register a relationship
both partners must complete: Parts 1-6
both partners must provide the required
identification (page 3).
provide payment details (page 9).
one partner to prove NSW residency (page 4)
OR
To lodge a notice to withdraw
(cancel your application)
within the 28-day cooling off period.
at least one partner must complete a
declaration (page 11).
at least one partner must provide the required
identification (page 3).
Options to lodge
By post
Please attach clear copies certified by
an authorised witness. Do not mail originals.
NSW Registry of Births Deaths & Marriages
GPO Box 30, Sydney NSW 2001
In Person
Please provide original ID to be certified and ha
Parts 3 and 6 signed before lodging in person.
At a Registry BDM office.
Monday to Friday: 8:00am 4:30pm
At a Service NSW Service Centre.
www.service.nsw.gov.au
BDM Office Locations
35 Regent Street Chippendale NSW 2008
160 Marsden Street Parramatta NSW 2150
Contacting Us - Phone: 13 77 88
Service NSW | Monday to Friday (7am7pm)
NRS: 1300 555 727
(Speech/hearing impaired)
TIS: 131 450
(Translating/interpreting service)
www.bdm.nsw.gov.au
ve
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 3 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Identification for each partner
This section is to apply to register a relationship (or withdraw).
You must provide three forms of identification, one of each from categories 1, 2 and 3.
If you are unable to provide identification from category 1, you must still provide at least three
forms of identification. At least one of these must be from category 2 and two from category 3.
The person who is residing in NSW must provide at least one identification document
containing a current NSW residential address (see category 4).
All identification must be current (not expired). Utility bills or rate notices must have been
issued within the last three months.
Identity documents issued by overseas authorities must be translated into English by an
accredited translator, i.e. National Accreditation Authority for Translators and Interpreters
(NAATI).
If applying in person, you must bring the original documents.
If applying by post, you must enclose certified photocopies of each identity document. Do not
send original documents with your application. See Page 1 for a list of Authorised Witnesses.
A certified identity document is a photocopy which an Authorised Witness says is a true copy
of the original.
Category 1
If born in Australia:
An Australian birth certificate
If born overseas:
New Zealand citizenship certificate
New Zealand birth certificate
Australian citizenship certificate
ImmiCard
Certificate of registration by descent
Category 2
Australian driver licence
Australian passport
Australian firearm licence
Foreign passport
Photo Card issued by a government agency
Visa
Category 3
Medicare card
Credit or debit card
Centrelink card
Australian Department of Veteran’s Affairs
card
Australian security guard licence or crowd
control licence
Student or tertiary identity card
Overseas birth certificate
Category 4
(For acceptable documents in Category 4,
please see the next page.)
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 4 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Category 4 Proof of residency in NSW
At least one partner must reside in NSW and must provide an identity document from Category 4
with a current residential address.
Alternatively, the partner can provide either a current NSW driver licence or a current NSW photo
card ID. This would be both a Category 2 and Category 4 document.
For proof of residential address, bank statements and any document with a Post Office Box are
not accepted.
Examples of documents
These may include, but are not limited to the following types of documents.
Do you own your own home?
Rates notices
Water rates
Utility bills
Land valuation certificate
Home insurance papers
Or, do you rent your home?
Agent lease agreement with rental history
ledger
Bond lodgement notice
Content insurance papers
Utility bills
Department of Housing rental ledger
Do you work?
ATO Notice of Assessment
Or, are you currently unemployed?
Centrelink payment advice
Centrelink ledger, with address history
University / TAFE transcripts
Do you own a vehicle?
Insurance papers
Registration papers
E-toll statements
Infringement notices
What other documents do you have?
Other government letters
Electoral enrolment confirmation
Superannuation documents
Private health care statements
Note: If you change your residential address within the 28-day cooling off period, you must notify
the Registry in writing with a certified copy of your updated Driver Licence or Centrelink Card or
any documents from Category 4 to minimise delays.
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 5 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Partner ONE
PART 1: Details
PART 2: Marital Status & Parents
Family name
Current marital status
Never validly married
Family name at birth
De facto
Given name(s)
Mother or Parent family name
Mother or Parent family name at their birth (maiden
Dat
e of birth
Sex
Male
dd / mm / yyyy
Female
Mother or Parent given names
Ot
her
Place of birth: City/State
Father or Parent family name
Pl
ace of birth: Country
Father or Parent family name at their birth (maiden)
Oc
cupation
Father or Parent given names
Current residential address
Unit Number
Suburb/Town/City
False representation
If you knowingly provide false information in this
application, you may be guilty of an offence under
State/Territory Postcode
Section 57 of the BDMR Act.
False representation: A person who makes a
representation in an application, notice or
Country
document under this Act or in response to a
notice under Section 44 of this Act (Registrar’s
powers of inquiry), knowing the representation to
Daytime contact number
be false or misleading in a material particular, is
guilty of an offence. Maximum penalty: 100
penalty units or 2 years imprisonment, or both.
Email
)
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 6 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
PART 3: Partner ONE - Statutory Declaration
I declare that: (NOTE: declaration must be completed in the presence of an authorised witness)
I consent to the relationship being registered in the I have read and understand all the instructions in this
state of NSW.
document including Your Right to Privacy and
I declare that all statements in this declaration are true
Disclosure of Information.
and correct:
I understand it is an offence to make false or misleading
representations in this declaration and penalties may
I am 18 years of age or above; I am not rel
ated
apply.
by family to the other person in this
relationship; I am not married.
I understand this form becomes the property of NSW
I am not registered under this Act or a
Registry of Births Deaths & Marriages who may confirm or
corresponding law as being in a registered
verify the information provided and may disclose to
relationship or an interstate registered
persons or bodies with adequate entitlement the
relationship.
information under the Relationships Register Act 2010 or
Access to information contained in the Register Policy.
Partner ONE: Full name
I declare for the purposes of the Relationships Register Act 2010 that I am in a relationship with:
Partner TWO full name
Partner ONE Signature (signed in the presence of an authorised witness*) Date signed
dd/mm/yyyy
AUTHORISED WITNESS: I certified the following matters concerning the making of this statutory declaration by
the person who made it (*please cross out any text that does not apply):
1.
*I saw the face of the person OR * I did not see the face of the person because the person was wearing a face
covering, but I am satisfied that the person had a special justification for not removing the covering, and
2.
*I have known the person for at least 12 months OR * I have not known the person for at least 12 months, but I
confirmed the person’s identity using an identification document and the document I relied on was:
ID document sighted
Declared at
(suburb/location) in the state of on
dd / mm / yyyy
Before me (signature of authorised witness) Full name of authorised witness (BLOCK LETTERS)
Address of authorised witness
Address of authorised witness
Suburb/Town/City Postcode Country
Daytime contact number Email
Tick the correct title of authorised witness
Justice of the Peace (write JP No.) Legal Practitioner
(with current Australian
practising certificate)
British Consular Officer Judge/Magistrate Public Notary
Australian Consular Officer
Note: * the date signed and the date declared must be the
same day, having been dealt with within minutes of each other.
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 7 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Partner TWO
PART 4: Details
PART 5: Marital Status & Parents
Family name
Cur
rent marital status
Never validly married
Family name at birth
De facto
Given name(s)
Mother or Parent family name
Mother or Parent family name at their birth (maiden)
Date of birth
Sex
Male
dd / mm / yyyy
Female
Mother or Parent given names
Other
Place of birth: City/State
Father or Parent family name
Place of b
irth: Country
Father or Parent family name at their birth (maiden)
O
ccupation
Father or Parent given names
Current residential address
Unit Number
Suburb/Town/City
False representation
If you knowingly provide false information in this
State/Territory Pos
tcode
application, you may be guilty of an offence under
Section 57 of the BDMR Act.
Country
False representation: A person who makes a
representation in an application, notice or
document under this Act or in response to a
noti
ce under Section 44 of this Act (Registrar’s
Daytime contact number
powers of inquiry), knowing the representation to
be false or misleading in a material particular, is
guilty of an offence. Maximum penalty: 100
Email
penalty units or 2 years imprisonment, or both.
Application to register
a relationship
Relationships Register Act 2010 (NSW)
Page 8 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
PART 6: Partner TWO - Statutory Declaration
I declare that: (NOTE: declaration must be completed in the presence of an authorised witness)
I consent to the relationship being registered in the I have read and understand all the instructions in this
state of NSW.
document including ‘Your Right to Privacy’ and
I declare that all statements in this declaration are true
Disclosure of Information’.
and correct:
I understand it is an offence to make false or misleading
representations in this declaration and penalties may
I am 18 years of age or above; I am not related
apply.
by family to the other person in this
relationship; I am not married.
I understand this form becomes the property of NSW
I am not registered under this Act or a
Registry of Births Deaths & Marriages who may confirm or
corresponding law as being in a registered
verify the information provided and may disclose to
relationship or an interstate registered
persons or bodies with adequate entitlement the
relationship.
information under the Relationships Register Act 2010 or
Access to information contained in the Register Policy.
Partner TWO: Full name
I declare for the purposes of the Relationships Register Act 2010 that I am in a relationship with:
Partner ONE full name
Partner TWO Signature (signed in the presence of an authorised witness*) Date signed
dd/mm/yyyy
AUTHORISED WITNESS: I certified the following matters concerning the making of this statutory declaration by
the person who made it (*please cross out any text that does not apply):
1.
*I saw the face of the person OR * I did not see the face of the person because the person was wearing a face
covering, but I am satisfied that the person had a special justification for not removing the covering, and
2.
*I have known the person for at least 12 months OR * I have not known the person for at least 12 months, but I
confirmed the person’s identity using an identification document and the document I relied on was:
ID document sighted
Declared at
(suburb/location) in the state of on
dd/mm/yyyy
Before me (signature of authorised witness) Full name of authorised witness (BLOCK LETTERS)
Address of authorised witness
Address of authorised witness
Suburb/Town/City Postcode Country
Daytime contact number Email
Tick the correct title of authorised witness
Justice of the Peace (write JP No.) Legal Practitioner
(with current Australian
practising certificate)
British Consular Officer Judge/Magistrate Public Notary
Note: * the date signed and the date declared must be the
Australian Consular Officer
same day, having been dealt with within minutes of each other.
Page 9 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Payment details to
register a relationship
Relationships Register Act 2010 (NSW)
PRINT clearly in BLACK or BLUE pen. Complete all details.
Certificates will be mailed to you and incur a postage and handling fee.
Payment includes (non-refundable) application fee and Relationship certificate.
Do you require a letter confirming you have lodged this application?
YES (Fee applies)
What quantity of Standard relationship certificate/s do you require? e.g.1 (enter number)
Optional: Add Commemorative relationship certificate/s: ‘Sydney Harbour
Opera House
Optional: Do you wish to organise a Relationship Ceremony with the Registry?
(Fee applies)
If yes, see next page for details and choose: Chippendale or Parramatta
Reason certificate is required (e.g. visa) Your relationship to the person registered (e.g. self)
APPLICANT DETAILS
Family name
Given name(s)
Address Suburb/Town/City
State/Territory Postcode Country
Postal Address Suburb/Town/City
(if different)
State/Territory
Postcode
Country
Phone number
Email address
Signature
International Registered Post
of applicant
(if required)
DETAILS OF PARTNERS REGISTERING A RELATIONSHIP
Partner ONE
Family name Given name/s
Date of birth
dd / mm / yyyy
Partner TWO
Family name Given name/s
Date of birth
dd / mm / yyyy
PAYMENT DETAILS (Complete this section for all mail applications). Refer to fees at: bdm.nsw.gov.au
*Cheques payable to NSW Registry of Births Deaths & Marriages
Please debit: AMEX Mastercard Visa or enclosed is a cheque*/money order
Expiry date
mm / yyyy
Total Amount $
Signature of
cardholder
Surcharge applies to credit card payments at the rate
of 1.4% for AMEX and 0.4% for Mastercard or Visa.
ABN 30 854 211 521. GPO BOX 30 Sydney NSW 2001
Card number
Cardholder name
1
Page 10 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Relationship ceremony and/or
commemorative certificate/s
Relationships Register Act 2010 (NSW)
Celebrate this special moment!
Why not celebrate this special moment in your life with a relationship ceremony and/or
commemorative relationship certificate/s! These are optional when you register your relationship.
Relationship ceremony
This optional extra brings you together with your loved one (after the 28-day cooling off period is
over) for the presentation of a ceremonial relationship certificate.
If you select the option of a ceremony at the top of page 9, we will contact you to organise a date,
time and venue at one of the Registry’s venues - either at the Chippendale or Parramatta
Registries.
Notes:
1.
A relationship ceremony does not constitute a legal marriage
2.
This information is for Registry ceremonies only and not for weddings performed by
independent Marriage Celebrants.
You can make payment with this form
Please indicate at the top of Page 9 when you order your standard Relationship certificate/s.
See website for details.
Commemorative relationship
certificates
The perfect way to remember your special day!
can be purchased as a package with a standard
relationship certificate;
are available to purchase on their own;
presented in a framing size of 279mm x 355mm;
printed on archival paper, wrapped in tissue
Opera House Sydney Harbour
paper and packaged in a protective cylinder;
are for decorative purposes and may not be accepted by organisations as proof of identity.
You can apply for a commemorative relationship certificate if your relationship is registered in NSW.
They are available to either person named on the certificate or their authorised representative.
How to order
To make your selection of beautiful commemorative relationship certificate/s, please indicate at
the top of Page 9 when you order your standard Relationship certificate/s.
Page 11 of 11
Form 3 Application to Register a Relationship. Effective as of 1 July 2019.
Notice to withdraw
Application to register relationship
Relationships Register Act 2010 (NSW)
NOTE: You need to complete this page ONLY if you decide to WITHDRAW
your application for a relationship within the 28-day cooling off period.
Eligibility
If you have applied to register a relationship and wish to withdraw the application, one OR both
partners na
med on the original application must complete this section of the form.
Before the relationship has been registered, the applicant may withdraw an application whether or not
the 28 day cooling off period has passed.
There is no fee to withdraw, however application fees are non-refundable.
I/we would like a refund for the certificate/s fee including registered mail (tick box)
I/we would like a refund for the Relationship Ceremony fee (tick box)
PART 7: Partner ONE Declaration PART 8: Partner TWO Declaration
I (full name of Partner ONE) I (full name of Partner TWO)
Date of birth
Date of birth
dd / mm / yyyy
dd / mm / yyyy
Place of birth: City/State & Country
Place of birth: City/State & Country
Residential address
Residential address
Suburb/Town/City Postcode
Suburb/Town/City Postcode
Country
Country
I request that the application to register a
I request that the
application to register a
relationship with:
relationship with:
(full name of Partner TWO)
(full name of Partner ONE)
Be withdrawn from the date of this application
Be withdrawn
from the date of this application
Certified copies of three forms of my
Certified copies of three forms of my
identification are attached to this form
.
identification are attached to this form
.
Partner ONE Signature
Partner TWO Signature
Date signed
Date signed
dd / mm
/ yyyy
dd / mm / yyyy
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome