Complete on-screen and print
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You must still print off the application and sign it by hand
BDM93B • Page 1/3
He tono mō tētahi Tiwhikete Whānautanga o Aotearoa, Tānga rānei
Request for New Zealand Birth Certificate or Copy of Record
If you are ordering a certificate for your new baby you must register their birth first. Register
your child and order a certificate at the same time at https://smartstart.services.govt.nz
SECTION 1: Certificate details
Surname or family names (required)First and middle names (required)
Town or city of birth
Parent 1 full names
Date of birth (required)
Parent 2 full names
SECTION 2: Delivery address and contact details
Delivery name
Flat no Street no Street name
Suburb or rural locality
City, town or district
Postcode
Country (if not New Zealand)
Applicant's contact phone number Applicant's email address
Last updated: 26 September 2019
To order certificates online
visit www.govt.nz/bdm
Other information (e.g. folio number)
If you intend to use the certificate overseas refer to www.govt.nz/authentications
Complete on-screen and print
You can complete this form on-screen using the Editable PDF functionality with Adobe Reader
You must still print off the application and sign it by hand
BDM93B • Page 2/3
SECTION 3: Certificate style and quantity
Standard Forest Beach All Blacks
Copy
of Record
Enter quantity Price
This is a copy of the birth record usually used for genealogical
research and is not a legal document. It may be typed or handwritten.
$33
$35
$35
$35
$55
$55
$55
$25
SECTION 4: Delivery method and payment
Sections 5 and 6 on the next page are not required if the birth certificate you are ordering is more than 100 years old,
or was a still-birth more than 50 years ago.
The certificate will be sent folded with the
delivery address printed on the back.
I want the certificate(s) or copy of the record couriered to a New Zealand address
I want the certificate(s) or copy of the record couriered to an overseas address
I am ordering a copy of the record and want it emailed
I want the certificate(s) sent by standard post
I am ordering a copy of the record and want it sent by standard post
$5
Australia, Asia, Pacific $15
USA $20
Europe $25
Rest of the world $30
$0
Standard birth certificate
Copy of the Record
Value pack: All Blacks style decorative + standard certificate
Value pack: Beach style decorative + standard certificate
Value pack: Forest style decorative + standard certificate
All Blacks style decorative certificate
Beach style decorative certificate
Forest style decorative certificate
If the record cannot be found we will contact you and search fees will apply
$0
$0
Select how you will pay
I have enclosed a New Zealand cheque or International bank draft in NZ dollars made out to the
Department of Internal Affairs. Note: Australian money orders can only be receipted at the Sydney office.
Prezzy card
Do not post cash
Visa Mastercard American Express
Card number Expiry date
Cardholder signatureName on card
Do not post us
your prezzy card
Complete on-screen and print
You can complete this form on-screen using the Editable PDF functionality with Adobe Reader
You must still print off the application and sign it by hand
SECTION 5: Proof of identity
We check your details in this form against another identity record
I am ordering my own birth certificate
I am ordering my child's birth certificate
I was born in New Zealand
I was married or entered into a civil union in New Zealand
My child was born in New Zealand
OR include a photocopy of one of the
following identity documents:
BDM93B • Page 3/3
Town or city of marriage or civil union
Date of marriage or civil union
Child's date of birth
Child's full name
SECTION 6: Declaration
My surnameMy first and middle names
My first and middle names at birth (if different) My surname at birth (if different)
Copy from Section 1
I am ordering on behalf of a company, and have included a signed request on company letterhead
I declare that the information above is true and correct. I understand that any person who makes a false statement
will be liable on conviction to a fine or imprisonment, or both. I understand the information on this form is collected
under the Births, Deaths, Marriages, and Relationships Registration Act 1995. As part of processing my request, I
understand that my identification details will be checked against other records held by the Department of Internal
Affairs or other government agencies, as authorised by law. I understand that my name will be recorded on the access
register for any non-historical certificates that I order.
Date signed
My signature
Submit your form
and payment
By mail In person
Certificate Team
Births, Deaths and Marriages
PO Box 10526
Wellington 6143
New Zealand
Visit www.govt.nz/bdmoffices for the
location of offices in Auckland,
Manukau, Wellington, Christchurch,
Sydney and London
My town or city of birth, and country if not NZMy date of birth
Do not send the original
- Passport (NZ or overseas)
- Driver Licence (NZ or overseas)
- 18+ Card (issued by Hospitality NZ)
- NZ Firearms or Dealer’s Licence
- Salvation Army identity certification
- NZ Refugee Travel Document
- NZ Emergency Travel Document
- NZ Certificate of Identity (Issued by
Immigration NZ)
- NZ Certificate of Identity (Issued under the
Passport Act 1992)
- Steps to Freedom document (issued by
Department of Corrections)
Choose one of the following to confirm your identity
Office Use Only B D
- Kiwi Access Card (issued by Hospitality NZ)
Print
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