Register Name Change

8/3/2019 Register Name Change

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BDM400

WESTERN AUSTRALIABirths, Deaths and Marriages Registration Act 1998

APPLICATION TO REGISTER CHANGE OF NAME1. WHO CAN APPLY (please note that these are general instructions only)

Change Of Name For An AdultIf you are an adult (18 years and over) you may apply for a change of name if:(a)

You were born and/or your birth is registered in Western Australia; or

You are a permanent resident of Australia and are ordinarily a resident in WesternAustralia; or

You are an Australian citizen and are ordinarily a resident in Western Australia(b)

An adult whose name is being changed must complete Part A. If their spouse or de factpartner is also changing their name, then Part B must be completed.

(c)

If born in Western Australia a birth certificate is not necessary, however if born interstatea birth certificate must be provided

(d)

If born overseas, your birth certificate and current passport must be provided [also referto point 2(b)]. If you are an Australian citizen, you must also provide yourAustralian Citizenship Certificate

(e)

Applicants who have changed their name by marriage and are applying for a change ofname must provide a certified copy of their marriage certificate if married interstate oroverseas

(f) Proof of any previously registered name change must be provided

Change Of Name For A ChildIf you are under 18 years of age and have not been married, your parents may apply tochange your name on your behalf if:(a)

You were born and/or your birth is registered in Western Australia; or

You are a permanent resident of Australia and are ordinarily a resident in WesternAustralia; or

You are an Australian citizen and are ordinarily a resident in Western Australia(b

)

If both parents are recorded in the childs birth registration, PART C must be completed

by them unless: An order from the Family Court (telephone 08 9224 8222) is provided with this

application; or

One parent makes an application and the other parent is deceased. A deathcertificate must be provided; or

Both parents are deceased (death certificates required), cannot be found or fosome other reason cannot exercise their parental responsibilities, the childs guardiacan apply by completing PART C. Proof of guardianship must be provided

(c)

One parent may apply if they are the sole parent named in the childs birth registration -complete PART C

(d

)

If the child was born in Western Australia a birth certificate is not necessary, however if

the child was born interstate or overseas, a full birth certificate recording parents detailsmust be provided [also refer to point 2(b)]. If the child has Australian Citizenship,the Citizenship certificate must also be provided

(e)

Proof of any previously registered name change must be provided

(f) Children aged 12 years or over must also sign the consent section

2. DOCUMENTATION(a)

Photocopies of original documents will only be accepted if they are certified as a true ancorrect copy by a Justice of the Peace or a solicitor

(b)

Overseas documents must be translated into English by an accredited translator

3. NOTIFICATION(a)

Any person whose birth is registered in Western Australia will have the new name notedon their birth registration An amended birth certificate can be obtained on payment of


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BDM400

(c)

Name changes may be notified to other organisations such as the Police Department,Passport Office, Department of Immigration & Citizenship etc

4. COMPLETING THE APPLICATION FORM(a)

Legally married or de facto couples (whether of different or same sex) and sole parents &their children under 18 years of age may apply on one form N.B. Marriage/birth certificator evidence of de facto relationship must be provided. Refer to page 4.

(b)

Print clearly. Symbols and abbreviations must notbe used

(c

)

Initial all alterations and do notuse correction fluid otherwise the form will not be

accepted(d)

Pay the scheduled fee (see page 4), which includes the issue of a change of namecertificate

(e)

Please allow a minimum of five (5) working days to process your application, plus afurther ten (10) working days if paying by personal cheque

(d)

Faxed application forms will not be accepted

Note:

You can only change your name once in any 12 month period unlessthere are exceptional circumstances. This does not apply if you are revertingto your immediate past name

It is an offence to make a false or misleading statement in anyapplication or document under the Births, Deaths and Marriages Registratio

Act 1998Postto: Registry of Births, Deaths and Marriages

-OR- Bring the completed form to:

PO Box 7720 Cloisters Square, PERTH WA 6850Level 10, 141 St Georges Terrace,PERTH

For enquiries 1300 305 021 Web site:www.dotag.wa.gov.au

Office hours: 8.30am to 4.30pmMonday to Friday


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PART A ADULT WHOSE NAME IS BEING CHANGEDIf born in Western Australia, the change of name will be recorded on your birth registratioand will appear on all birth certificates issued after registration of the name change (thRegistrar may grant an exemption in exceptional circumstances e.g. Court order, domestviolence).

If born Interstate, this office will notify your birth state of your name change.

CURRENT Surname:

NAME Given

NEW Surname:

NAME Given

REASON

FOR

NAME

Single Married Defacto Divorced Widowed Separated

PERSONAL Dateofbirth

/ /Fullnameat birth

DETAILS Place ofbirth:

Town

State

Country

If born overseas, are you an Australian citizen? Yes (attach copy of Citizenship plusbirth certificate/passport) No

Residentialaddress

Daytime TelephoneNumber

P/code

Postal

address P/code

MARRIAGE

Date of 1st marriage

/ /Place of 1st marriage

Date of 2nd marriage

/ /Place of 2nd marriage

DETAILS Date of 3rd marriage

/ /

Place of 3rd marriage

Full name prior to last marriage

Have you previously registered a name change (not including marriage)? Yes

(attach copy) No

SIGNATUREDate: / /

PART B SPOUSE / DE FACTO PARTNER (IF NAME IS ALSO BEINGCHANGED)

CURRENT Surname:

NAME Given

NEW Surname:

NAME Given

REASON

FOR

NAME

PERSONAL

Dateofbirth

/ /Fullnameat birth

DETAILS Place ofbirth:

Town

State

Country

If born overseas are you an Australian citizen? Yes (attach copy of Citizenship plus


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MARRIAGE

Date of 1st marriage

/ /Place of 1st marriage

Date of 2nd marriage

/ /Place of 2nd marriage

DETAILS Date of 3rd marriage

/ /Place of 3rd marriage

Full name prior to last marriage

Have you previously registered a name change (not including marriage)? Yes

(attach copy) No

SIGNATUREDate: / /


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PART C CHILD WHOSE NAME IS BEING CHANGED (Children aged 12 years orover must also sign the consent section)

Please contact the Registryon 1300 305 021 for further advice if: the child was born in WA, is under 12 months of age and only the given name (s) are to bechanged; or the natural parents marry after their childs birth; or the natural fathers details are to be included in the childs birth registration.

If born in Western Australia, the change of name will be recorded on your childs birtregistration and will appear on all birth certificates issued after registration of the namchange (the Registrar may grant an exemption in exceptional circumstances e.g. Couorder, domestic violence).If born Interstate, this office will notify the birth state of your childs name change.

DETAILS OF PERSON/S APPLYING ON BEHALF OF CHILD/REN

Mothers name: Fathers name:

Relationship to child/ren: Mother Father Parents

Guardian

Residential address:

P/code Daytime Tel No. Postaladdress P/code

REASON FOR NAME CHANGE

CHILD 1

CURRE Surnam Givenname s :

NEWNAME

Surname:

Givenname s :

Date of / / Place ofPrevious name change: Yes Full name at

name

Surname:

name s :

NAMESurname:

name s :

Full name at


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Childs signature (if aged 12 or over): Date / /

If there are more than 2 children changing their names, please request another form or attacha separate list with their details.


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OFFICE USE ONLY

FEES (Free of GST)

(Prices are subject to change without further notice)Change of name fee..............................................................................................................................................$156.00

Birth Certificate (Western Australian birth).............................................................................................................$ 44.00

IF YOU HAVE CHANGED YOUR NAME AND WISH TO PURCHASE AN AMENDED BIRTH CERTIFICATEFOR YOURSELF AND/OR CHILD, PLEASE COMPLETE THIS SECTION

Name of person whose certificate you are requesting Date of BirthBirth

CertificateQuantity

/ // // // // // /

PAYMENT DETAILS

Enclosed is a cheque/money order for $ OR debit my MasterCard or Visa for

$

Cheques should be made payable to the Registrar of Births, Deaths and Marriages

(NOTE: If paying by personal cheque, please allow an additional 10 working days to process)Card No. Expiry Date /

Name ofcardholder

Signature ofcardholder

Extract from Section 13A Western Australian Interpretation Act regarding de factrelationship and de facto partner

(1) A reference in a written law to a de facto relationship shall be construed as a reference to arelationship (other than a legal marriage) between 2 persons who live together in a marriage-likerelationship.

(2) The following factors are indicators of whether or not a de facto relationship exists between persons, but are not essential


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support, between them;

the ownership, use and acquisition of their property (including property they own individually);

whether they care for and support children.(3) It does not matter whether

the persons are different sexes or the same sex

This information is not exhaustive. If required, please contact the Registry.


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HELP US TO PROTECT YOUR

IDENTITY AND REDUCE FRAUD

Identity fraud involving the use of stolen, fictitiousor altered identities to perpetrate serious criminaloffences is a matter of growing communityconcern.

The Western Australian Registry recognises thatcertificates and changes of name help toestablish a person's identity and is committed tomaintaining the security of its information byreducing the risk of certificates being wrongfullyissued to people who may use them forfraudulent purposes.

Applicants are now required to provide a range ofcommonly available documents before beingeligible to receive certificates or register achange of name. For a childs change of nameboth parents named on the birth certificate arerequired to provide identification.

When providing information or certificates fromrecords held at the Registry, the Registrar musthave regard for the privacy of the person towhom the record relates. For example a birthcertificate is usually only available to the person

named in the certificate, their parent or legalguardian etc.

For further information regarding the accesspolicy, visit our website at www.dotag.wa.gov.auand follow the links or telephone the Registry on1300 305 021.

If you are applying for a certificate or registering a change ofname, you must provide:

ONE form ofcurrent identification from List 1

OR

TWO forms of

current identification from List 2OR

THREE formsof current identification from List 3plus

ONE form of current identificationfrom List 2

If applying in person, original documents must beprovided. When applying by post please send

clear photocopies of your identificationdocuments with your application.

Identification that has expired, for example adrivers licence, will not be accepted as a form ofidentification.

LIST 1 LIST 2 LIST 3

Australian driverslicence (with photo)

Australian firearmslicence (with photo)

Australian passport

Defence force orpolice service photoidentity card

Department ofImmigration andCitizenship (DIAC)certificate ofevidence ofresidence status

(with photo)

Australian drivers licence withoutphoto

Centrelink or Department ofVeterans Affairs card

Citizenship certificate Credit or debit card Current overseas passport with

current Australian entry permit DIAC immigration papers Health Care card Medicare card Proof of age card Security guard/crowd control

licence Student card Tertiary education student ID card

Bank statement withcurrent residentialaddress

Educational certificate/

school report Electricity account withcurrent residentialaddress

Gas account withcurrent residentialaddress

Motor vehicleregistration

Shire/water rates Telephone account

with current residential

address Trade certificate

Registry of Births, Deaths & MarriagesWestern Australia
http://www.bdm.wa.gov.au/http://www.bdm.wa.gov.au/


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Identification of the person (from Lists 1, 2 or 3) who is entitled to the document as stated in theRegistrys certificate access policy;

and

A letter giving permission from the person entitled to the document.


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Registry of Births, Deaths and MarriagesWestern Australia

PROOF OF RESIDENCY

REQUIREMENTS FORCHANGE OF NAME

Births, Deaths and Marriages Registration Act 1998

If you wish to apply for a change of name in Western Australia and you werenot born in the State, to be eligible you must be:

a permanent resident of Australia and ordinarily reside in

Western Australia; or an Australian citizen and ordinarily reside in WesternAustralia.

Note: You must provide a minimum of two separate forms ofdocumentary evidence that you have been living or have beenordinarily resident in Western Australia for the three (3) monthsimmediately preceding your application.

Evidence of residency must be in the form of documentation thatstates your current address, such as:

WA drivers licence if photocopy is provided, include both sides;

electricity or gas account;

shire/water rates;

telephone account; or

bank statements.

Please note:

The Registrar can refuse to register a change of name.

The Registry will not accept any papers that do not have a dateof issue displayed.

Evidence of your current residency can not be older than threemonths (except your WA photo drivers licence).

In extraordinary circumstance the Registry may accept evidenceof residency older than three months but not older than sixmonths. You must discuss this with Registry staff before lodgingyour application.


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The Registry may at its discretion conduct checks withappropriate agencies to verify the information in your applicationincluding the authenticity of your documentation.

Registrar of Births, Deaths and MarriagesRegistry of Births, Deaths & Marriages, 141 St Georges Terrace, Perth6000 Ph: 1300 305 021

Documents

Register Name Change