Birth Certificate Application 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 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). PEACEFUL Date of issue: 3 August 2017 Birth Certificate Male Oliver Harry Lewis 05 April 2016 St George Private Hospital, Kogarah Sonia Anna Lewis Blacktown, NSW Luke Steven Lewis Blacktown, NSW 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 BIRTH CERTIFICATE Date of birth: Sex: PARENTS Given names: Surname: Place of birth: Place of birth: Given names: Surname: Place of birth: Date of issue: Jonathan Robert Smith FAUNA Hunter Wren Citizen 1 July 2016 Female Parents Dawn Citizen Chippendale, NSW David Citizen Chippendale, NSW Armidale NRL - CLUB OR STATE OF ORIGIN Female Jennifer Edwina Lenna Citizen 01 December 2015 New Lambton Heights Judith Amber Rose Citizen Blacktown Alex Lee Citizen New Lambton Heights STANDARD BIRTH CERTIFCATE (A4 SIZE) KEN DONE Sarah Wilson GIGGLE & HOOT RAINBOW BIRTH CERTIFICATE Date of birth: Sex: PARENTS Given names: Surname: Place of birth: Place of birth: Given names: Surname: Place of birth: Date of issue: Jonathan Robert Smith 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 locations Monday to Friday 8am–4.30pm ■ 35 Regent St, Chippendale ■ 160 Marsden St, Parramatta or at Service NSW service centres www.service.nsw.gov.au Service NSW Monday to Friday (7am–7pm) Hearing/Speech impaired ■ TTY/Voice 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
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Birth Certificate Application - New South Wales · Birth Certificate Application. You can apply online for birth certificates or use this form to apply for: • a standard birth certificate,
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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.
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.
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.
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.