*** Transcriber's Note: Please set your voice synthesiser to read most punctuation. When you encounter the caret sign (^) at the end of a line, please enter the applicable information, if necessary. ***

Department of Internal Affairs – Te Tari Taiwhenua

BDM93D

Request for New Zealand Death Certificate or Copy of record 
Tono Tiwhikete Mate o Aotearoa, Tānga rānei 

Last updated 23 May 2024

To order certificates online visit www.govt.nz/bdm 
If you want to use the certificate overseas refer to www.govt.nz/authentications 

SECTION 1: Certificate details 

Deceased's surname (required) ^
Deceased's first and middle names (required) ^

Date of death (required) ^
Place of death (town or city) ^

Spouse/Partner's full name (if any) ^

Deceased parent 1 full names ^
Deceased parent 2 full names ^

Other information (e.g. folio number) ^

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 ^

SECTION 3: Certificate style and quantity 

Select the certificates you want, and write the quantity you want of each 

Death certificate $33. The certificate will be sent folded with the delivery address printed on the back). (Enter quantity) ^
Copy of the Record $25. This is a copy of the death record usually used for genealogical research and is not a legal document. It may be typed or handwritten. (Enter quantity) ^

If the record cannot be found we will contact you and search fees will apply 

SECTION 4: Delivery method and payment 

I want the certificate(s) sent by standard post for $0. (Yes or no) ^
I want the certificate(s) or copy of the record couriered to a New Zealand address which costs $5. (Yes or no) ^
I want the certificate(s) or copy of the record couriered to an overseas address which costs between $15 to $30. (Yes or no) ^
Australia, Asia, Pacific courier costs $15.
USA courier costs $20.
UK, Europe courier costs $25.
Rest of the world courier costs $30.
I am ordering a copy of the record and want it emailed for $0. (Yes or no) ^
I am ordering a copy of the record and want it sent by standard post for $0. (Yes or no) ^

Complete payment details at the end of this form. 

Sections 5 and 6 are not required if the death certificate you are ordering is more than 50 years ago or the deceased’s date of birth is more than 80 years ago 

SECTION 5: Proof of identity 

We check your details in this form against another identity record 
Choose one of the following to confirm your identity 
I was born in New Zealand (Yes or no) ^
I was married or entered into a civil union in New Zealand (Yes or no) ^
Date of marriage or civil union ^
Town or city of marriage or civil union ^ 
My child was born in New Zealand (Yes or no) ^
Child's date of birth ^
Child's full name ^

OR include a photocopy of one of the following identity documents: (Yes or no) ^
-Passport (NZ or overseas) 
-Driver Licence (NZ or overseas) 
-Kiwi Access Card (issued by Hospitality NZ) 
-18+ Card (issued by Hospitality NZ) 
-NZ Firearms or Dealer’s Licence 
-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) 

Do not send the original 

SECTION 6: Declaration 

My first and middle names ^
My surname ^
My first and middle names at birth (if different) ^
My surname at birth (if different) ^
My date of birth ^
My town or city of birth, and country if not NZ ^

I am ordering on behalf of a company, and have included a signed request on company letterhead (Yes or no) ^

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 2021. 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. 

My signature ^
Date signed ^

Submit your form and payment 

By mail 
Certificate Team 
Births, Deaths and Marriages 
PO Box 10526 
Wellington 6140 
New Zealand 

Contact details www.govt.nz/bdm/contactus

Payment 
Do not post cash or card 
Please charge my credit card (Visa, MasterCard, American Express, Prezzy) 
Card number ^
Card expiry date ^
Name on card ^
Cardholder signature ^