Birth CertificateApplication

You can apply online for birth certificates or use this form to apply for:

• a standard birth certificate, and/or

• a commemorative birth certificate.

See website for fees and turnaround times.

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 right).

If you DON’T meet the above criteria, you must provide:

A “Letter of Authority giving permission to apply” available on our website: www.bdm.nsw.gov.au

• Three types of ID from the person giving permission (see right).

• Three types of your own ID (see right).

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.bdm.nsw.gov.au

Fax information to a Passports office

Select 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.bdm.nsw.gov.au

Commemorative birth certificates

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 3

If born in Australia:■ An Australian birth certificate

Record 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 withcurrent 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).

PEACEFUL

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 CertificateMale

Oliver Harry 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

HANDPRINT PINK (FOUR OPTIONS)

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.

PEPPA PIG FAMILY

© ABD Ltd/Ent. One UK Ltd 2003.

BIRTH CERTIFICATE

Date of birth:Sex: PARENTSGiven 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 organisationsmay 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

FAUNA

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 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 Citizen

Date of Birth: 1 July 2016

Sex: Female

Parents

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

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

Place of Birth: Armidale

NRL - CLUB OR STATE OF ORIGIN

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 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 2015Date of Birth

New Lambton HeightsPlace of Birth

Parents:

Judith Amber RoseGiven Names

CitizenSurname

BlacktownPlace of Birth

Alex LeeGiven Names

CitizenSurname

New Lambton HeightsPlace of Birth

STANDARD BIRTH CERTIFCATE (A4 SIZE)

KEN DONE

Date of birth: 29 June 2017

Sex: Female

PARENTSGiven names: Samantha

Surname: O’Brian

Place of birth: Sydney, NSW

Sarah Wilson

Place of birth: Sydney, NSW

Given names: Tom

Surname: Wilson

Place of birth: 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

GIGGLE & HOOT RAINBOW

© Australian Broadcasting Corporation 2019

BIRTH CERTIFICATE

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.

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 organisationsmay not accept it as a proof of identity document.

Jonathan Robert Smith29 June 2015

Male

Lillian Maureen

Done

Salisbury, Wiltshire, England

Siesta Private Hospital, Croydon Park

Clifford Wade

Done

Wolverhampton, Staffordshire, England

29 June 2015

A 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.

Online Lodging by post

You can lodge this application online at:www.bdm.nsw.gov.au

GPO Box 30 SYDNEY NSW 2001

Lodging in person Phone: 13 77 88

Registry office locationsMonday to Friday 8am–4.30pm■ 35 Regent St, Chippendale■ 160 Marsden St, Parramattaor at Service NSW service centreswww.service.nsw.gov.au

Service NSW Monday to Friday (7am–7pm)Hearing/Speech impaired■ TTY/V oice Call 133 677■ NRS 1300 555 727 Translating and Interpreting■ TIS National 131 450

Capture the joy of a new birth, or celebrate a birth from many years ago with a commemorative birth certificate. You can choose a standard birth certificate only, a commemorative only, or both together.

All commemorative birth certificates come in a popular framing size (279mm x 355mm) and are mailed separately to the standard certificate (A4 size).

Commemorative certificates do not contain security features and organisations may not accept them as proof of identity. You may need a standard birth certificate for official purposes (e.g. to apply for a driver licence). See www.bdm.nsw.gov.au for all the latest designs.

Form 7

Certificate entitlement

YOU CAN COMPLETE THIS

APPLICATION ONLINE AT:

bdm.nsw.gov.au

ABN 30 854 211 521 GPO Box 30 Sydney NSW 2001 Tel: 13 77 88Birth Certificate Application

Your certificate will be mailed to you if your application was received by post and will incur a postage and handling fee.

PRINT clearly in BLACK pen and complete all details. Do you require Priority processing* of your application? Yes Fee applies, see www.bdm.nsw.gov.au

Would you like us to fax your certificate* to an Australian passport office/DFAT office? Yes Fee applies, see www.bdm.nsw.gov.au

Passport/DFAT office name & location: You must have already made arrangements with the Passport/DFAT office* Only applies to standard certificates, not to commemoratives

DETAILS OF PERSON COMPLETING THIS FORM. Please provide copies of at least three types of current ID 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 address

Signature ✗ I certify that I understand the provisions overleaf on Identification, Privacy & Disclosure and that the information I have provided is true and correct.

of applicant

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 detailsFamily name Family name at birth (Current)

First given name Other given name/s

Parent 2 detailsFamily name Family name at birth (Current)

First given name Other given name/s

PAYMENT DETAILS (complete this section for mail applications only). Please refer to www.bdm.nsw.gov.au for fees.

Total Amount $ . Please debit my: AMEX Mastercard Visa OR Enclosed is a cheque*/money order

Card number * Cheques payable to NSW Registry ofBirths Deaths & Marriages (Non Priority only)

Name Expiry date mm / yyof cardholder

Signature ✗ A surcharge applies to credit card payments at the rate of 1.4% for AMEX and 0.4% for Mastercard or Visa.of cardholder

Please select quantity of standard birth certificate/s you wish to receive e.g. 1 certificate/s. International Registered Post

Select design and quantity of commemorative certificates Describe the commemorative(s) you require: e.g. ‘1 Fauna and 1 NRL Sharks (Member #123456 joined 1988)’you wish to receive e.g. 1 certificate/s.

For NRL certificates you can add your Club membership number and year you joined the Club.

Reason certificate is required Your relationship to the registered person (e.g. PASSPORT, SCHOOL) (e.g. SELF, PARENT, CHILD)

Form 7 Application for a Birth Certificate. Effective 1 July 2019.