Birth CertificateApplication

Applying for a birth certificateA standard birth certificate is an official certified 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 certificate, or a parent of the person named on the certificate, the birth certificate 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 PrivacyWhen 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

Identification (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 3If born in Australia:• An Australian birth certificateRecord of immigration status:• Citizenship certificate• New Zealand citizenship

certificate• New Zealand birth certificate

• Medicare card• Credit or debit card• Centrelink or Department of

Veterans Affairs 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 CitizenDate of Birth: 16 March 2018

Place of Birth: ArmidaleMy Parents

Given Name(s): DawnSurname: Citizen

Place of Birth: Chippendale, NSW

My ParentsGiven Name(s): David

Surname: CitizenPlace 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 – JOINED 1995

Date of Issue: Date of IssueI hereby certify that this is a true copy of particulars

in the Register in the State of New South Wales,

in the Commonwealth of Australia.

Registry of Births Deaths & Marriages NSW

FemaleSex

Jennifer Edwina Lenna Citizen

01 December 2015

Date of Birth

New Lambton Heights

Place of Birth

Parents:Judith Amber Rose

Given NamesCitizenSurnameBlacktownPlace of Birth

Alex LeeGiven NamesCitizenSurnameNew 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

Clifford Wade

Done

Wolverhampton, Staffordshire, England

29 June 2015

Jonathan Robert Smith

OnlineYou can complete this online at www.nsw.gov.au/bdm

Lodging by postGPO Box 30 SYDNEY NSW 2001

Lodging in personService 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 officeSelect this option to send your certificate if you have made prior arrangements with the Australian Passport office, consulate or embassy. This only applies to standard certificates, not commemoratives. Fee applies, see www.nsw.gov.au/bdm

Commemorative birth certificatesDid you know? You can buy a Commemorative on its own, and it makes an ideal gift perfect for framing!

Commemorative certificates 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

ParentsGiven 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

100Celebrating

YEARS1918-2018

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:

ParentGiven 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 & CuddlepieNovember 1918Neutral Bay, NSWTwo little boys

Cecilia MayGibbsSydenham, 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

ParentsGiven 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 2013I hereby certify that this is a true copy of particulars in the Register in the State of New South Wales, in the Commonwealth of Australia.

Registry of Births Deaths and Marriages NSW

Hunter Wren CitizenDate of Birth: 1 July 2016Sex: Female

Parents

Given Name(s): DawnSurname: CitizenPlace of Birth: Chippendale, NSW

Given Name(s): DavidSurname: CitizenPlace 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 IssueI hereby certify that this is a true copy of particulars

in the Register in the State of New South Wales,

in the Commonwealth of Australia.

Registry of Births Deaths & Marriages NSW

FemaleSex

Jennifer Edwina Lenna Citizen01 December 2015Date of Birth

New Lambton HeightsPlace of Birth

Parents:

Judith Amber RoseGiven NamesCitizen

Surname

BlacktownPlace of Birth

Alex LeeGiven NamesCitizen

Surname

New Lambton HeightsPlace of Birth

Sex: Female

Hunter Wren 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

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.

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.

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 2017Issued 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 CertificateFemale

Hazel Nicola Lewis05 April 2016Date of Birth

St George Private Hospital, KogarahPlace of Birth

Parents:

Sonia AnnaGiven Names

LewisSurname

Blacktown, NSWPlace of Birth

Luke StevenGiven Names

LewisSurname

Blacktown, NSWPlace 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 88Birth Certificate 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 identification 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 different from above)

State/Territory Postcode Country

Phone number Email International Registered Post

Signature of applicant ✗

I certify that I understand the provisions overpage on Identification, 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 certificate/s do you require? Standard birth certificate/s (enter number) For NRL certificates you can add your Club membership number and year you joined the Club.

Commemorative certificate/s (enter number) Enter description e.g. 1 Fauna and 1 NRL Sharks (Member 123456 joined 1988) Commemorative

Reason certificate 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 certificate* sent to an Australian passport office/DFAT office? Yes

Passport/DFAT office name and the location: You must have already made arrangements with the Passport/DFAT office

* Priority processing and Passport options are only for standard certifcates and not commemorative. See website for fees.

Form

7 0

6/20

20

YOU CAN COMPLETE THIS APPLICATION ONLINE AT: www.nsw.gov.au/bdm