*** 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 BDM75 Application to register a name change and update sex marker on birth certificate — Aged 15 and under Tono ki te rēhita i te huri ingoa me te whakahou tohu ira tangata ki te tiwhikete whānau — 15 tau me raro iho Last updated 02 April 2024 Use this form to register a name change for your child and update the sex marker on your child’s New Zealand birth certificate if: • your child’s birth was registered in New Zealand • all your child’s guardians consent, and • your child is aged 15 or under. Me whakamahi i tēnei puka hei rēhita i te huri i te ingoa mō tō tamaiti me te whakahou i te tiwhikete whānau o Aotearoa o tō tamaiti mēnā: • i rēhitatia te whānautanga mai o tō tamaiti i Aotearoa • e whakaae ana ngā kaitiaki katoa, ā, • 15 tau me raro iho tōna pakeke. Before you apply | Hei mua i te tononga Guidelines for your child’s new name Your child’s new name must consist of one surname and one or more other names. If your religious or philosophical beliefs, or cultural traditions require your child to only have one name, you will need to attach a letter of explanation. The new name (or combination of names) may not be accepted for registration if it: • might cause offence to a reasonable person • is more than 70 characters long, including spaces, without adequate justification • is, includes, or resembles an official title or rank (in which case attach a letter of explanation), or • is not a name (for example, it must not include numbers or symbols). Guidelines for your child’s new sex marker You will need to select one of the following sex markers for your child: • female • male • non-binary. Timeframe To view our current timeframes for updating your child’s sex marker, go to: govt.nz/bdmtimeframes If you have requested a certificate showing your child’s new name and sex marker, allow extra time for postage. If the application is not correct and complete, the application may be delayed. Contact details Website: govt.nz/bdm/contactus Email: bdm.nz@dia.govt.nz Only use email for enquiries about the form. To return the form, follow the postage instructions at the end of this form. Do not email the completed form to us. True statements If you make, or cause to be made, any false statement or declaration you will be liable, on conviction, to a fine or up to 5 years imprisonment, or both. Requirements You will need to: 1. Have all your child’s guardians’ consent. 2. Provide a Letter of Support from a qualified third party. 3. Provide a certified true copy of all guardians’ current photo identification. 4. Include supporting documents to establish your identity. 5. Have all guardians make a statutory declaration in sections 6 to 12 of this form. Refer to below for further information about these requirements. 1. Guardian consent What is a guardian? A legal guardian is an adult who’s responsible for the upbringing and care of a child. This is often both parents of the child. In some circumstances, it can be one parent or someone additional appointed by the Family Court. You will need all of your child’s guardians to provide a signature to show consent to your application to update your child’s sex marker. If your child only has one guardian, or any additional guardians, your application will need to include a court document to show them being appointed. For one parent this is usually called a Sole Guardianship Order, or if your child has more than two guardians, an Additional Guardianship Order. What if a guardian does not consent? You are able to apply to change your child’s name and registered sex by obtaining a Family Court order that may direct the Registrar-General to change the name and registered sex of your child. 2. Letters of support You must provide a letter of support from a suitably qualified third party. The following professionals can provide a letter of support if they are registered in New Zealand: • doctors • psychologists • psychotherapists • nurses • social workers • registered counsellors You can also get a letter of support from a person aged 18 years or over who has known your child for 12 months or more. What does the third party need to do? The role of a third party will be to provide a letter of support that confirms that your child: • understands what it means to update the sex marker on their birth certificate; and • it is something that they want to do. The third party is not assessing if the change is in your child’s best interest or if they physically conform to the sex marker you have requested. 3. Guardians’ current photo identification All guardians must provide a certified true copy of one of the following. They must include your photos. • New Zealand or overseas passport (photo page only) • New Zealand or international driver licence (copy of front and back) • New Zealand or overseas firearms or dealer’s licence • New Zealand or overseas defence force or police service photo identity card • Overseas identity card • 18+ card or Kiwi Access Card (issued by Hopitality New Zealand) or overseas proof of age card • New Zealand Emergency Travel Document • New Zealand Certificate of Identity (issued under the Passports Act 1992) • New Zealand Certificate of Identity (issued under the Immigration Act 2009) • New Zealand Refugee Travel Document A certified true copy is a photocopy that has been stamped or endorsed by an authorised person. For example, a solicitor/lawyer, notary public, registrar of the court or Justice of the Peace. This confirms that the copy is a true copy of the original document. If you do not have photo identification, you will also need to fill out an Identity referee declaration form (BDM76) and attach it to this application. You can find this form at: govt.nz/birth-certificate-sex You must present your current photo identification or completed BDM76 form (with attached photo) to the person authorised to take a statutory declaration when you sign the declaration in front of them. They can certify your document at the same time. 4. Proof of the use of your identity in the community You must provide two documents from different sources. These do not need to be certified true copies. For example: • Rates notices • Electoral roll record • Motor vehicle registration • Student or tertiary identity card • Educational certificate or school report • Trade certificate • Steps to Freedom form • Community Services Card • Utility accounts (including gas, water, electricity, mobile or home phone) • Bank statements (including savings, credit or cheque accounts) • Lease or tenancy agreements • Inland Revenue tax number (provide an IR card or statement) • Certificate of Approval or licence issued by the Private Security Personnel Licencing Authority 5.Statutory declaration requirements A statutory declaration is a written statement signed in front of an authorised person and declared to be true. The people below are authorised to take a statutory declaration. New Zealand: • Registrar of Births, Deaths and Marriages • Justice of the Peace • Registrar or a deputy registrar of the Supreme Court, Court of Appeal, High Court or a District Court • Person enrolled as a barrister and solicitor of the High Court • Any other person authorised by law to administer an oath Non-Commonwealth country: • Commonwealth representative • Notary public • Judge • Solicitor of the High Court of New Zealand Commonwealth country other than New Zealand: • Commonwealth representative • Justice of the Peace • Notary Public • Judge • Commissioner of Oaths • Solicitor of the High Court of New Zealand • A person authorised by law to administer an oath for the purpose of judicial proceeding (examples below) Examples of people authorised by the law of Australia, England, Wales, Ireland, Northern Ireland and Scotland to administer an oath for the purpose of judicial proceeding: Australia Note: Australian Police are not authorised to take this statutory declaration unless you are in the Northern Territory. Note: Australian pharmacists, optometrists and doctors are not authorised to take statutory declarations. • Judge • Notary public • Justice of the Peace • Solicitor of the High Court of New Zealand • Australian legal practitioner • Court clerk or registrar who certifies their authority to take an oath for a judicial proceeding • Commonwealth representative Also, if in Northern Territory • Commissioner for Oaths (by personal appointment) • Member of the Legislative Assembly • Member of the house of the Parliament of the Commonwealth elected to represent the Territory or a constituency in the Territory • Member of the police force who is 18 years or older Also, if in Queensland • Commissioner for Declarations • Conveyancer Also, if in South Australia • Commissioner for Affidavits Also, if in Western Australia • A mining registrar appointed under the Mining Act 1978 Also, if in Queensland • Commissioner for Declarations • Conveyancer England or Wales • Judge • Comissioner of Oaths (by personal appointment) • Notary public • Justice of the Peace • Solicitor of the High Court of New Zealand • Solicitor • Barrister • Legal executive • Licensed conveyancer • Court clerk or registrar who certifies their authority to take an oath for a judicial proceeding • Commonwealth representative Ireland or Northern Ireland • Judge • Notary public • Justice of the Peace • Solicitor • Court clerk or registrar who certifies their authority to take an oath for a judicial proceeding • Commonwealth representative • Solicitor of the High Court of New Zealand Scotland • Judge • Notary public • Justice of the Peace • Commonwealth representative • Person authorised by the law of that country to administer an oath for the purpose of a judicial proceeding • Solicitor of the High Court of New Zealand Privacy statement The information provided on this form is collected under the Births, Deaths, Marriages, and Relationships Registration Act 2021 (the ‘BDMRR’ Act). A person who makes, or causes to be made, a false declaration on this form will be liable on conviction to a fine or term of imprisonment, or both. The new information will be held on a public register and may generally be accessed by any person on application (e.g. as a certificate or printout). The Department of Internal Affairs (‘The Department’) may also release it to certain government agencies and foreign registration authorities, as authorised by law. The Department will notify the Passport service and the RealMe Identity Verification Service of the change in birth information accordance with section 107 of the BDMRR Act to ensure you do not have more than 1 identity recorded. This form and the details relating to your sex at birth will not be publicly available, except where the Registrar-General is satisfied the information is required in relation to the administration of an estate or trust, a marriage, or by order of a Court. A new birth registration will be made from the information provided. Corrections may be made as provided for in the BDMRR Act. The BDMRR Act governs access to registered information. Information about your rights to access and, where appropriate, correct the information is available on our website govt.nz/bdm or freephone 0800 22 52 52. Fees statement All fees are correct as at the form version date. All fees are in New Zealand dollars. Instructions: • You can complete this form by hand or on-screen using Adobe Reader. • You can use the Tab key to move to the next fillable form field in Adobe Reader. • You must still print off the application and sign where applicable by hand. Please read the ‘Before you apply’ section of this application form carefully before you start. If your application is not correct and complete, your application may be delayed or unsuccessful. 1. My child’s name 1a. Name at birth This is the name on your child’s birth certificate. All first and middle names ^ Surname ^ 1b. Name from previously registered name change (if applicable) This applies if your child’s current name is different from their name at birth due to a registered name change. All first and middle names ^ Surname ^ 2. My child’s date of birth Date (dd/mm/yyyy) ^ 3. My child’s place of birth Town/city ^ Country ^ 4. Indicate whether you want your attached documents to be: Securely destroyed (Yes or no) ^ Returned to you (Yes or no) ^ 5. All guardians’ contact details 5a. Guardian 1’s contact details Guardian 1’s full name ^ Guardian 1’s phone number ^ Guardian 1’s email address ^ 5b. Guardian 2’s contact details (if applicable) Guardian 2’s full name ^ Guardian 2’s phone number ^ Guardian 2’s email address ^ 5c. Guardian 3’s guardian’s contact details (if applicable) Guardian 3’s full name ^ Guardian 3’s phone number ^ Guardian 3’s email address ^ 5d. Guardian 4’s contact details (if applicable) Guardian 4’s full name ^ Guardian 4’s phone number ^ Guardian 4’s email address ^ The next section is the Statutory Declaration. You will need to sign it in front of an authorised person. Refer to 'Statutory declaration requirements' in the preceding guide notes for the list of people authorised to take a Statutory Declaration. Statutory declaration All your child’s guardian(s) need to fill out this section. If your child has more than 2 guardians, print a second copy of this section for the additional guardian(s) to fill in and sign. Attach these pages to your application. Take care completing this statutory declaration as you may be required to do it again if there are errors. All corrections must be: • initialled • dated, and • witnessed by a person authorised to take a statutory declaration. By completing this statutory declaration I declare that: I authorise any necessary additional enquiries including the disclosure of personal information about myself or the person whose name is being changed for the purpose of determining eligibility for the name change part of the application. My authorisation includes any information held by the Department of Internal Affairs or another NZ government agency. Are all guardians acting together to complete this declaration or is one guardian acting alone? I am acting alone as a guardian (yes or no) ^ We are all guardians acting together (yes or no) ^ If you are acting alone, fill in Section 6 below. If all guardians are acting together, fill in Section 7. 6. Acting alone as a guardian There are 6 statements to choose from. Select the statement that applies: Statement 1: I, as the child’s mother, am the sole guardian because the child was conceived on or after 1 July 2005 and I was not married to, nor in a civil union with, the father of the child at anytime during the period beginning with the conception of the child and ending with the birth ofthe child; and I was not living with the father of the child as a de facto partner at any time duringthat period, and none of the exceptions below apply. Yes or no ^ Exceptions to statement 1: • The mother and father jointly registered the birth on or after 1 July 2005 by completing and signing the Notification of Birth for Registration form (BDM27). • The father’s particulars were included in the child’s birth information on or after 1 July 2005but no later than 24 January 2009. • A testamentary guardian of the child has been appointed by the deceased parent under section 26(2) of the Care of Children Act 2004 or section 7(2) of the Guardianship Act 1968. • The Court has appointed any other person(s) a guardian. Statement 2: I, as the child’s mother, am the sole guardian because the child was born as a result of an assisted reproduction procedure (such as donor insemination) to me acting alone, and the donor is not my partner (i.e. not in a marriage, civil union or de facto relationship), and the donor did not become my partner between conception and notification of the birth for registration. Yes or no ^ Statement 3: The Family Court has given consent for me to act alone. Yes or no ^ If this is the case, attach a copy of the Family Court order (this is not a Parenting order, previously known as a Custody order). Statement 4: The guardian is unable to act because of a medical condition or they are of unsound mind. Yes or no ^ If this is the case, provide evidence from a registered medical practitioner. Statement 5: The guardian(s) is/are dead. Yes or no ^ If they died in New Zealand, enter the deceased’s name, date of death and place of death. If they died overseas, include a certified true copy (or original) of the deceased’s death certificate. Full name of first deceased guardian ^ Date of death (dd/mm/yyyy) ^ Place of death (town or city and country) ^ Full name of second deceased guardian ^ Date of death (dd/mm/yyyy) ^ Place of death (town or city and country) ^ Statement 6: The guardian(s) is/are missing. Yes or no ^ State the recent actions within the last 2 months that you have taken to contact the other guardian(s) and include the date you tried to contact them. This includes searching the electoral roles, the Internet, asking family and friends or former employers. You must also state that you and all the people that know the guardian (which you have contacted) have no way of contacting them below. I/we searched the electoral roles on this date: Date (dd/mm/yyyy) ^ I/we searched the Internet on this date: Date (dd/mm/yyyy) ^ I/we asked family members on this date: Date (dd/mm/yyyy) ^ I/we asked friends on this date: Date (dd/mm/yyyy) ^ I/we asked their employers on this date: Date (dd/mm/yyyy) ^ State yes or no to confirm: I/we and all people who known the guardian(s), who I/we have contacted, have no way of contacting the guardian(s). Yes or no ^ If you could not attempt to contact the guardian with one of the above methods, attach a letter of explanation. 7. Guardian 1’s full name, occupation, and residential address Guardian 1’s full name ^ Guardian 1’s residential address Street number and name ^ Suburb ^ Town or city ^ Country ^ Guardian 1’s occupation Enter your occupation, for example, ‘Landscape gardener’ or ‘Home-maker’. If you have no occupation, enter ‘No occupation’. ^ 8. Guardian 2’s full name, occupation, and residential address Guardian 2’s full name ^ Guardian 2’s residential address Street number and name ^ Suburb ^ Town or city ^ Country ^ Guardian 2’s occupation Enter your occupation, for example, ‘Landscape gardener’ or ‘Home-maker’. If you have no occupation, enter ‘No occupation’. ^ 9. The name I/we want to register on my/our child’s birth certificate is: Refer to the ‘Guidelines for your child’s new name’ at the start of this form. All first and middle names ^ Surname ^ 10. I/we advise that my/our child intends to use their new name once their name is registered (yes or no) ^ Note: If your child is already using their new name, answer 'yes'. 11. I/we solemnly and sincerely declare that: • my/our child identifies as a person of the sex marker selected below, and • my/our child understands that their future birth certificates will show the selected sex marker in the sex field. Select one: Female (yes or no) ^ Male (yes or no) ^ Non-binary (yes or no) ^ All guardians need to sign this statutory declaration. Guardian 1 should fill out section 12 in front of the authorised person. Guardian 2 should fill out section 14 in front of the authorised person (if applicable). 12. Guardian 1 must fill out and sign this section before a person authorised to take a statutory declaration (Refer to 'Statutory declaration requirements' in the preceding guide notes for the list of authorised people.) I solemnly and sincerely declare that the information herein in this statutory declaration is accurate and complete and I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957. Declared at (Town or city, and country) ^ this day of (dd/mm/yyyy) ^ by (Signature of applicant) ^ 13. The person authorised to take a statutory declaration must complete this section. I am satisfied of the applicant’s identity because (select one): I have sighted the applicant’s original photo identification document from the list at the beginning of this form (write document name and number below). Yes or no ^ I have sighted the applicant’s photo on a fully completed BDM76 Identity Referee form. Yes or no ^ Document name (e.g. New Zealand passport) ^ Document number (e.g. Passport number) ^ Signature (Authorised person signs here) ^ Full name of authorised person ^ Qualification of authorised person ^ 14. Guardian 2 (if applicable) must fill out and sign this section before a person authorised to take a statutory declaration. (Refer to 'Statutory declaration requirements' in the preceding guide notes for the list of authorised people.) I solemnly and sincerely declare that the information herein in this statutory declaration is accurate and complete and I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957. Declared at (Town or city, and country) ^ this day of (dd/mm/yyyy) ^ by (Signature of guardian) ^ 15. The person authorised to take a statutory declaration must complete this section. I am satisfied of the applicant’s identity because (select one): I have sighted the applicant’s original photo identification document from the list at the beginning of this form (write document name and number below). Yes or no ^ I have sighted the applicant’s photo on a fully completed BDM76 Identity Referee form. Yes or no ^ Document name (e.g. New Zealand passport) ^ Document number (e.g. Passport number) ^ Signature (Authorised person signs here) ^ Full name of authorised person ^ Qualification of authorised person ^ End of Statutory Declaration. Continue to sections 16 to 19 of the form. 16. Human Assisted Reproductive Technology Register (HART) Is your child born as a result of a HART procedure? Yes or no ^ If 'yes', continue to fill in this section. If 'no', go to Section 17. This section applies if your child was born as a result of an assisted reproductive technology procedure using donated sperm, eggs or embryos through a fertility clinic. If the information has been provided to Births, Deaths and Marriages for inclusion on the HART Register, it will be updated to include your child’s new name. This means that up-to-date information will be provided to persons who are authorised to access your child’s information under the Human Assisted Reproductive Technology Act 2004. Donation made after 21 August 2004 If your child’s birth occured as a result of a donation made after 21 August 2004, information will be sent to a fertility clinic. We can send information about the name change to the fertility clinic. They can then update their records. Yes, I consent to my child’s new name being sent to the fertility clinic named below that holds the information: (yes or no) ^ Fertility clinic name ^ 17. Fees The application fee to register a name change is $170. The application fee to update a sex marker is $55. Birth certificate (additional fee) You can order a birth certificate if you need a certificate that shows your child’s new details. If you do not need a certificate to prove your child’s new details, this is optional. There are several types and packages of birth certificate that you can select from. Enter quantity: Standard certificate $33 ^ Forest style decorative certificate $35 ^ Beach style decorative certificate $35 ^ Two certificate package: beach style decorative and standard $55 ^ Two certificate package: forest style decorative and standard $55 ^ 14. Birth certificate delivery If you have ordered a birth certificate, select a delivery method: I want the certificate(s) sent by standard post ($0). Yes or no ^ I want the certificate(s) couriered to a New Zealand address ($5). Yes or no ^ I want the certificate(s) couriered to an overseas address ($15 to $30). Yes or no ^ Costs for overseas courier: Australia, Asia, Pacific: $15 USA: $20 Europe (unless listed under 'Rest of world'): $25 Rest of world: $30. 'Rest of world' includes: Azerbaijan, Armenia, Bulgaria, Bosnia and Herzegovina, Cyprus, Croatia, Greece, Georgia, Macedonia, Malta, Moldova Contact us if you are unsure whether we can deliver to your country. Contact information is at the start of this form. Delivery address: Delivery name ^ Street number and name ^ Suburb ^ Town or city ^ Country ^ Postcode ^ Next, complete the payment section. 15. Payment Do not post cash or card. Do not email credit card details. Charge my credit or debit card (Visa, MasterCard, American Express, Prezzy Card): Yes or no ^ Card number ^ Card expiry date (MM/YY) ^ Name on card ^ Cardholder signature ^ Next steps 1. Print and sign the form. 2. Post the form, appropriate fee(s), and documents to us. New Zealand office: Births, Deaths and Marriages Department of Internal Affairs PO Box 10-526 Wellington 6140 New Zealand Sydney office: Births, Deaths and Marriages Department of Internal Affairs GPO Box 365 Sydney New South Wales 2001 Australia London office: Births, Deaths and Marriages Department of Internal Affairs 1 Pall Mall East London SW1Y 5AU United Kingdom