*** 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. *** Office Use only: Batch / ^ Regn Nbr / ^ Internal Affairs Te Tari Taiwhenua BDM 27. Use smartstart.services.govt.nz to register the birth online. Notification of Birth for Registration of child born in New Zealand. He whakaaturanga o te Rehita Whanautanga o te tamaiti i whanau i Aotearoa. For help completing this form please contact us on Call free 0800 22 52 52 (New Zealand only). Phone: +64 9 339 0852 (if outside New Zealand). (A) The first character of each word must be a capital letter, except where the first letter is lower case. The remainder of each word must be in lower case. E.g. John Wellington. (B) You must answer all questions. Do not send us another form if you have already sent us one for your child. (C) All fees, timelines and entitlements are correct as at the form version date. You must answer all questions. Do not send us another form if you have already sent us one for your child. Why register? Every birth in New Zealand must be registered by law. Please register the birth of your child as soon as possible. We expect you to register the birth within two months. Both parents must jointly register the birth, with some exceptions. Birth registration is the first official step that confirms whether your child is a New Zealand citizen. You will not be sent any confirmation that the birth has been registered, however, you can purchase a birth certificate (see order form on the last page). How to register the birth. You may register the birth online at smartstart.services.govt.nz or use this form. Please take care filling out this form as if you make a mistake you will need to pay for a new birth certificate to be issued, if required. Name change fees will also apply. • Print the names of your child the way you would like them to appear on a birth certificate. • Leave a space between names or words. • Answer all questions in the form truthfully. It is against the law to give false information. • Please ensure that all relevant questions are completed. • When you have completed the form, post it to: Birth Registrations Online, Births, Deaths and Marriage, PO Box 10526, Wellington 6140. What does it cost? Registration is free. However there is a fee for a Birth Certificate. Privacy. Information regarding the registration of your child’s birth is collected under the Births, Deaths, Marriages, and Relationships Registration Act 2021 (’the Act’). Both parents are primarily responsible for notifying the birth as soon as practicable. It is an offence, punishable by a fine, to fail or refuse to provide information for the registration of a birth. The citizenship or immigration details of the parent(s) of a child born on or after 1 January 2006 will be checked against databases held by the Department of Internal Affairs (Citizenship Office, Passports Office or Births, Deaths and Marriages), the Ministry of Business, Innovation and Employment (Immigration) and / or with registration authorities in the Cook Islands, Niue or Tokelau (where relevant). The information will be used to confirm whether your child is a New Zealand citizen by birth. If you decide to use this form to also apply for an IRD number for your child, Births, Deaths, and Marriages will give the information you have provided on this form to Inland Revenue for this purpose. After giving the information to Inland Revenue, Births, Deaths and Marriages will not retain details of your IRD number if you have provided it on this form. If you have decided to notify the Ministry of Social Development (MSD) of your child’s birth, Births, Deaths and Marriages will provide MSD with information about the birth when the registration is complete. MSD will use this information to determine how your new baby changes the benefits and services you are entitled to. After giving the information to MSD, Births Deaths and Marriages will not retain details of your MSD client number if you provided it on this form. The birth information collected on this form will be held on a public register. The Act governs access to registered birth information. Information about a named individual may generally be accessed by any person upon application (e.g. as a certificate or printout). Information may be released for statistical, or genuine health or demographic research in the public interest, or to certain government agencies, as authorised by law. Information about why the information is collected, the government agencies that are authorised to receive the information, and about a person's right to access and, where appropriate, correct the information, is available on our web site www.govt.nz/bdm, or Freephone 0800 22 52 52. www.govt.nz/bdm Form begins. Child. Child’s names to appear on a Birth Certificate (questions 1 & 2 below). Note. Your child must be registered with a surname or family name, and one or more given names. The name (or combination of names) may not be accepted for registration if, in the opinion of the Registrar-General of Births, Deaths and Marriages (or the Family Court on appeal); • it might cause offence to a reasonable person; or • it is unreasonably long (that is, it should be less than 70 characters long, including spaces); or • without adequate justification, it is, includes, or resembles, an official title or rank; or • it is not a name (for example, it must not consist of or include symbols that cannot meaningfully be expressed in language e.g. / or @). The name must consist of one name that is designated to be treated as the child's surname or family name, and one or more other names, unless the religious or philosophical beliefs, or cultural traditions of the person’s parent(s) or living guardian(s) require the child to have only one name. The child’s name will be registered exactly as entered below, if the name is acceptable for registration. Fees will apply if at a later date you decide to change or alter the child’s name (and the child’s previous name will appear on the certificate). To enter macrons or international characters refer to the keyboard shortcuts for your software (some are not supported). 1. All first or given name(s) of child. ^ 2. Surname or family name of child. ^ 3. Sex of child. Female. Yes or No. ^ Male. Yes or No. ^ Indeterminate. Yes or No. ^ Indeterminate means your doctor or midwife could not determine the sex of your baby. 4. Was this child alive at birth? No (the child was “stillborn”). ^ Yes. ^ A baby is stillborn if the baby was not alive when born, and: – weighed 400g or more at birth, or – was born after the 20th complete week of pregnancy. The delivery of a foetus in the 20th week of pregnancy or earlier, and which weighs less than 400g is a miscarriage and is not able to be registered. 5. Child's date of birth. (DD/MM/YYYY) ^ 6. Is this child one of multiple birth of twins, triplets etc? No. ^ Yes. ^ If yes is this child First twin Yes or No. ^ Second twin Yes or No. ^ First triplet Yes or No. ^ Second triplet Yes or No. ^ Third triplet Yes or No. ^ Other. ^ 7. Where was the child born? Hospital Yes or No ^ If child born in a hospital select from the list of 70 hospitals in Appendix A at the end of this form.^ Home birth. Yes or No. ^ Other Place. Yes or No. ^ If child not born in a hospital enter full address of birthplace. Address line 1. ^ Address line 2. ^ Address line 3. ^ If this child was born in a car or ambulance, also give the name of the hospital the mother and new child went to afterwards: Please select from the list of 70 hospitals in Appendix A at the end of this form. ^ 8. Is this child a descendant of a New Zealand Maori? No. ^ Yes. ^ Don't know. ^ Please make sure you answer the question “Descendant of a New Zealand Maori?” (i.e. do you have any Maori ancestors?). This information will not appear on the birth certificate. 9. Which ethnic group(s) does this child belong to? Select the group or groups that apply. Please select as many groups as you wish to describe the ethnic group(s) this child belongs to. Do the same when you answer the question for the mother and father. The information you give about the ethnicity of your child will help other government agencies to get a clear picture of our society so that health, education and other needs in your area can be planned for. NZ European. Yes or No ^ Maori. Yes or No ^ Samoan. Yes or No ^ Cook Island Maori. Yes or No ^ Tongan. Yes or No ^ Niuean. Yes or No ^ Chinese. Yes or No ^ Indian. Yes or No ^ Other such as Dutch, Japanese, Tokelauan... Please state ^ Mother. 10. Mother's name currently known by In question 10 put all first and given names and all family names or surnames. If any of these names are different from the name on your own birth registration, please also state the name you were given at birth (question 11). If you were adopted, please enter the name you were given when you were adopted (in question 11), not your name before you were adopted (if you know that). To enter macrons or international characters refer to the keyboard shortcuts for your software (some are not supported). All first or given name(s) of mother (name(s) currently known by). ^ Surname or family name of mother (name(s) currently known by). ^ 11. Mother's name given at birth (Fill in only if different from question 10 above). All first or given name(s) of mother (at birth). ^ Surname or family name of mother (at birth). ^ 12. Usual occupation, profession or job of mother (Enter mother's occupation, not the name of mother's employer). ^ 13. Mother's date of birth (DD Month YYYY) ^ 14. Mother's place of birth. City/town. ^ Country (if born overseas). ^ 15. Mother's home address. Flat number (if applicable). ^ Street number. ^ Street name. ^ Suburb or locality. ^ City/town or district. ^ Postcode. ^ Country (if not NZ). ^ 16. Is the mother a descendant of a New Zealand Maori? No. ^ Yes. ^ Don't know. ^ Please make sure you answer the question “Descendant of a New Zealand Maori?” (i.e. do you have any Maori ancestors?). This information will not appear on the birth certificate. 17. Which ethnic group(s) does the mother belong to? Select the group or groups that apply: Please select as many groups as you wish to describe the ethnic group(s) you belong to. NZ European. Yes or No ^ Maori. Yes or No ^ Samoan. Yes or No ^ Cook Island Maori. Yes or No ^ Tongan. Yes or No ^ Niuean. Yes or No ^ Chinese. Yes or No ^ Indian. Yes or No ^ Other such as Dutch, Japanese, Tokelauan... Please state. ^ 18. Citizenship or residency status of mother. Complete the following section to show if you were a New Zealand citizen, New Zealand permanent resident or Australian citizen/permanent resident, when your child was born. Your details will be checked against databases held by the Department of Internal Affairs, the Ministry of Business, Innovation and Employment (Immigration), and/or with registration authorities in the Cook Islands, Niue or Tokelau (where relevant). From 2006, a child born in New Zealand is a New Zealand citizen at birth only if at least one parent is a New Zealand citizen, or is entitled under the Immigration Act 2009 to be in New Zealand indefinitely (i.e. the parent has a residency visa, residency permit or permanent residency), or is entitled to reside indefinitely in the Cook Islands, Niue or Tokelau. Please select the relevant boxes and provide the necessary information about each parent’s citizenship or immigration status. If you were born overseas to New Zealand citizen parent(s), or you were born overseas and adopted by New Zealand citizen parent(s), Births, Deaths and Marriages needs to confirm whether you are a New Zealand citizen by descent. If your citizenship by descent has been recorded with the Citizenship Office, please state the date of your registration/ confirmation and Citizenship Certificate number. If you have not applied for registration or confirmation, please either: • contact the Citizenship Office: Freephone 0800 22 51 51 for registration or confirmation. A fee applies to the process; or • send documents that show that you were born to a New Zealand citizen parent. Contact the Citizenship Office: Freephone 0800 22 51 51 for information about the documents that are required. If you are unsure about your citizenship status, contact the Citizenship Office: Freephone 0800 22 51 51. If you are unsure about your immigration status, contact the Ministry of Business, Innovation and Employment (Immigration): • within New Zealand but outside of Auckland: Freephone 0508 558 855 • from Auckland: 09 914 4100 • outside of New Zealand: +64 9 914 4100. Is the mother a New Zealand citizen? No. ^ Yes. ^ Mother is either: born in New Zealand. Yes or No ^ born in Niue. Yes or No ^ born in the Cook Islands. Yes or No ^ born in Tokelau. Yes or No ^ If yes to one of the 4 options above enter your New Zealand Passport Number. ^ or a New Zealand citizen by Descent or Grant. Yes or No ^ Is the mother a New Zealand permanent resident? No ^ Yes ^ Is the mother a resident of the Cook Islands, Niue or Tokelau? No ^ Yes ^ Is the mother an Australian citizen or permanent resident of Australia? No ^ Yes ^ Passport/travel document number you entered New Zealand on: ^ 19. Mother's contact details if we have queries with this form. Mother's daytime contact number. ^ Mother's alternative contact number. ^ Mother's email address. ^ Father. Is father known? No ^ Yes ^ If no go to question 32 below. If yes enter father's details below. If a child was born as a result of an assisted human reproduction procedure (such as artificial insemination), the details in questions 20 to 29 should be completed as follows: (a) if the mother married, or entered into a civil union or de facto relationship with, a man who consented to the mother undergoing the procedure, that man’s details should be entered. Note: The Donor is generally not the father or other parent. (b) if the mother married or entered into a civil union or de facto relationship with a woman who consented to the mother undergoing the procedure, answer yes to the following question, enter the details of the mother’s partner, and complete the details in the rest of the form wherever details of “Father” are indicated.Her details will be shown on the child’s birth registration and birth certificates as either "Mother" or “Other parent” (instead of “Father”). If situation (b) applies, tick one what is her preference? Mother ^ or Other parent ^ 20. Father's name currently known by In question 20 put all first and given names and all family names or surnames. If any of these names are different from the name on your own birth registration, please also state the name you were given at birth (question 21). If you were adopted, please enter the name you were given when you were adopted (in question 21), not your name before you were adopted (if you know that). To enter macrons or international characters refer to the keyboard shortcuts for your software (some are not supported). All first or given name(s) of father (name(s) currently known by). ^ Surname or family name of father (name(s) currently known by). ^ 21. Father's name given at birth (Fill in only if different from question 20 above) All first or given name(s) of father (at birth). ^ Surname or family name of father (at birth). ^ 22. Usual occupation, profession or job of father (Enter father's occupation, not the name of father's employer). ^ 23. Father's date of birth. (DD MM YYYY) ^ 24. Father's place of birth. City/town. ^ Country (if born overseas). ^ 25. Father's home address. Copy mother's address. Yes or No ^ If no, please enter home address. Flat number (if applicable). ^ Street number. ^ Street name. ^ Suburb or locality. ^ City/town or district. ^ Postcode. ^ Country (if not NZ). ^ 26. Is the father a descendant of a New Zealand Maori? No. ^ Yes. ^ Don't know. ^ Please make sure you answer the question “Descendant of a New Zealand Maori?” (i.e. do you have any Maori ancestors?). This information will not appear on the birth certificate. 27. Which ethnic group(s) does the father belong to? Select the group or groups that apply: Please select as many groups as you wish to describe the ethnic group(s) you belong to. NZ European. Yes or No ^ Maori. Yes or No ^ Samoan. Yes or No ^ Cook Island Maori. Yes or No ^ Tongan. Yes or No ^ Niuean. Yes or No ^ Chinese. Yes or No ^ Indian. Yes or No ^ Other such as Dutch, Japanese, Tokelauan... Please state. ^ 28. Citizenship or residency status of father. Complete the following section to show if you were a New Zealand citizen, New Zealand permanent resident or Australian citizen/permanent resident, when your child was born. Your details will be checked against databases held by the Department of Internal Affairs, the Ministry of Business, Innovation and Employment (Immigration), and/or with registration authorities in the Cook Islands, Niue or Tokelau (where relevant). From 2006, a child born in New Zealand is a New Zealand citizen at birth only if at least one parent is a New Zealand citizen, or is entitled under the Immigration Act 2009 to be in New Zealand indefinitely (a permanent resident), or is entitled to reside indefinitely in the Cook Islands, Niue or Tokelau. Please select the relevant status and provide the necessary information about each parent’s citizenship or immigration status. If you were born overseas to New Zealand citizen parent(s), or you were born overseas and adopted by New Zealand citizen parent(s), Births, Deaths and Marriages needs to confirm whether you are a New Zealand citizen by descent. If your citizenship by descent has been recorded with the Citizenship Office, please state the date of your registration/ confirmation and Citizenship Certificate number. If you have not applied for registration or confirmation, please either: • contact the Citizenship Office: Freephone 0800 22 51 51 for registration or confirmation. A fee applies to the process; or • send documents that show that you were born to a New Zealand citizen parent. Contact the Citizenship Office: Freephone 0800 22 51 51 for information about the documents that are required. If you are unsure about your citizenship status, contact the Citizenship Office: Freephone 0800 22 51 51. If you are unsure about your immigration status, contact the Ministry of Business, Innovation and Employment (Immigration): • within New Zealand but outside of Auckland: Freephone 0508 558 855 • from Auckland: 09 914 4100 • outside of New Zealand: +64 9 914 4100 Is the father a New Zealand citizen? No. ^ Yes. ^ Father is either: born in New Zealand. Yes or No ^ born in Niue. Yes or No ^ born in the Cook Islands. Yes or No ^ born in Tokelau. Yes or No ^ If yes to one of the 4 options above enter your New Zealand Passport Number. ^ or New Zealand citizen by Descent or Grant. Yes or No ^ Is the father a New Zealand permanent resident? No ^ Yes ^ Is the father a resident of the Cook Islands, Niue or Tokelau? No ^ Yes ^ Is the father an Australian citizen or permanent resident of Australia? No ^ Yes ^ Passport/travel document number father entered New Zealand on: ^ 29. Father's contact details if we have queries with this form. Father's daytime contact number. ^ Father's alternative contact number. ^ Father's email address. ^ Parents. 30. Are there other children born from the same parent relationship? (This means other children with the same mother AND father as the new child. If this is the first child of the relationship, answer No) No. ^ Yes. ^ If yes, complete the following table giving the sex and date of birth for each child, but do not include the child you are registering now. Child 1. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 2. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 3. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 4. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 5. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 6. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 7. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 8. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD Month YYYY) ^ Child 9. Female. Yes or No ^ Male. Yes or No. ^ Non-binary. Yes or No. ^ Indeterminate. Yes or No. ^ Was the child Born alive? Yes or no. ^ Stillborn? Yes or No. ^ or has since died. Yes or No. ^ Date of birth (DD MM YYYY) ^ 31. What was the parents’ relationship with each other at the time of the child’s birth? Not every relationship where two people live together (and are not married, nor in a civil union) is a de facto relationship under the law. Being in a de facto relationship depends on the couple’s circumstances, including the couple’s ages, the length of the relationship, the degree to which the couple are mutually committed to a shared life together, and the extent to which they make their relationship known publicly, for example, to friends and family. It is important that you know whether or not you are in a de facto relationship before you select the de facto relationship box. If you are unsure whether you are in a de facto relationship, you should get advice from a lawyer. Married. Yes or No. ^ In a civil union. Yes or No. ^ In a de facto relationship. Yes or No. ^ Not married or in a civil union or de facto relationship. Yes or No. ^ Date of marriage/civil union (DD MM YYYY) ^ Place of marriage/civil union: City/town. ^ Country (if solemnised overseas). ^ Application for Best Start payments Best Start payments are sometimes referred to as the Best Start tax credit (BSTC) For all children born on or after 1 July 2018, the principal caregiver (who must be aged 16 or older) will receive up to $69 per week. Every principal caregiver is entitled to receive this payment in the child’s first year. Payment is for three years and will reduce in the second and third year if your family income is above $79,000. Payments will start once Paid Parental Leave (PPL) finishes. If your child was born before 1 July 2018 but had an expected due date after this, you may have the following options: · Parental Tax Credit (PTC) – 10 weeks maximum $2,200 or; · Best Start Tax Credit (BSTC) – up to $60 per week, maximum $3,120 first year. If you choose Parental Tax Credit, you can’t receive Best Start Tax Credit for that same child. Complete the information below if you would like to apply to receive Best Start payments. Note: Payments will start from 1 July 2018. Go to www.ird.govt.nz (search keywords: bstc) for more information. An IRD number will be created for your child if you choose to get the Best Start payments through Inland Revenue. 32. Do you or your partner want to receive Best Start Tax Credit payments? Yes ^ No Go to Q.43 ^ 33. Best Start payments are only available for children born on or after, or expected after 1 July 2018. What was the expected due date of this child? (DD Month YYYY) ^ 34. The principal caregiver must be at least 16 years old or over and is responsible for the day to day care of the child on a permanent basis. Someone caring for a child on a temporary basis, such as in a child care centre, is not a principal caregiver. To apply for Best Start payments we need to know who the principal caregiver is as Best Start payments can only be paid to this person. The principal caregiver will need to apply for Best Start. Who is the child’s principal caregiver? Unknown Yes Go to Q.43 ^ Mother Yes Provide the mother's IRD number ^ Father Yes Provide the father's IRD number ^ Other Yes ^ Inland Revenue will contact the principal caregiver. Provide their first name(s), surname and their daytime contact phone below then go to Q.43 to apply for your child’s IRD number Principle caregivers first and middle names ^ Principle caregivers surname ^ Principle caregivers daytime phone number ^ 35. Does the principal caregiver receive a benefit from the Ministry of Social Development (MSD)? Yes Go to Q.43 ^ No ^ 36. Does the principal caregiver currently receive Working for Families tax credits from Inland Revenue? Yes ^ An IRD number will be issued to this child, go to Q.43(a) No ^ Best Start and Working for Family payments can only be made to New Zealand tax residents. You are a tax resident in New Zealand if you: • are in New Zealand for more than 183 days in any 12-month period and haven't become a non-resident, or • have a 'permanent place of abode' in New Zealand, or • are away from New Zealand in the service of the New Zealand government. 37A. Will the child be resident and living in New Zealand when the primary caregiver is receiving Best Start payments? Yes go to Q.38 ^ No ^ 37B. Has the principal caregiver lived in New Zealand continuously for at least 12 months at any time? Yes ^ No Go to Q.43(a) ^ 37C. Will the principal caregiver be a tax resident when receiving Best Start payments? Yes ^ No Go to Q.43a ^ 38. Shared care is when the care of the child is divided between people in different households for at least a third of the time. In a shared care situation there will be more than one principal caregiver eligible for Best Start payments. Does this child live with someone else for more than two days a week (shared care)? No ^ Yes ^ Provide the contact details of the person that care is shared with so that Inland Revenue have this information if they need it to process your BestStart application Share care with: First and middle names ^ Share care with: Surname ^ Share care with: Daytime phone number ^ 39. Does the principal caregiver have a spouse or partner living with them? Yes ^ Enter the spouse or partner’s first name, surname and IRD number Spouse/partner’s: First and middle names ^ Spouse/partner’s: Surname ^ Spouse/partner’s: IRD number ^ No ^ Go to Q.41 40. Is the principal caregiver receiving or intending to apply for Paid Parental Leave (PPL) for this child? Yes ^ Note that Best Start payments start once Paid Parental Leave finishes No ^ 41. How often do you want to be paid? Weekly : $69.00 Yes ^ No ^ Fortnightly : $139.00 Yes ^ No ^ Yearly (as a lump sum) : $3,632.00 Yes ^ No ^ 42. Provide your bank account details Bank Branch Account number Suffix ^ Bank account holder's name ^ Credit union or building society account reference number (if applicable) ^ Application for your child’s IRD number. If you apply for your child's IRD number, Births, Deaths and Marriages will provide Birth Registration information to Inland Revenue so that it can create your child’s IRD number and help protect it from misuse. If you have any questions about requesting an IRD number, go to: • on how this information is used and protected go to www.ird.govt.nz/about-this-site/privacy/privacy-policy.html • about applying for an IRD number go to :www.ird.govt.nz/how-to/irdnumbers/individuals/ or • phone Inland Revenue on 0800 775 247 - keyword “newborn IRD number” If one of the parents is a New Zealand or Australian citizen, or has New Zealand or Australian permanent residency, or is a resident of the Cook Islands, Tokelau, or Niue, the easiest way for you to get an IRD number for your child is by using this birth registration form. It is free to apply for an IRD number and it saves you having to get another set of forms to apply for it later. You will need an IRD number for your child if you are applying for Working for Families Tax Credits or opening a KiwiSaver account or bank account in your child’s name. If you apply for an IRD Number for your child, you should receive it 25 working days after posting a correct and complete Birth Registration form. The IRD number will arrive separately to your child’s Birth Certificate, if you have requested one. If none of the parents are New Zealand or Australian citizens, or have New Zealand or Australian permanent residency, or are a resident of the Cook Islands, Tokelau, or Niue, then you may not be able to apply for an IRD number using this birth registration form. 32. I wish to apply for an IRD number for my child. No ^ Yes ^ If yes (a) Please choose ONE address Inland Revenue should post your child’s IRD number to: Birth certificate address (if requested on the last page of this form). Yes or No ^ Mother’s address (at question 15). Yes or No ^ Father’s address (at question 25). Yes or No ^ (b) I also wish to receive my child's IRD number by email. Yes or No ^ (c) If you have applied for Working for Families Tax Credits for this child please provide your IRD number. ^ Inland Revenue will add your child’s IRD number to your application. If you've already applied for Working for Families payments for your baby, make sure you include your own IRD number on the birth registration form — Inland Revenue needs this to give you the payments. When your baby is given an IRD number, Inland Revenue will add it to your Working for Families registration details for you. Notify the Ministry of Social Development (MSD) of the birth If you are an existing Ministry of Social Development (MSD) client you should notify MSD to determine how your new baby changes your benefits and services. You can choose to have Births, Deaths and Marriages notify MSD when the birth is registered. MSD will then contact you as quickly as possible to discuss how your benefits and services will change. This means you do not need to provide a birth certificate to MSD and may not need to visit an MSD office. http://www.workandincome.govt.nz/about-this-site/privacy-disclaimer-and-copyright-information.html 33. I give permission for Births, Deaths and Marriages to notify the Ministry of Social Development of the birth of my child I am not an existing MSD client – go to page 9. Yes or No ^ No, I do not give permission. Yes or No ^ Yes, I give permission. Yes or No ^ If yes please provide the MSD client number of one or both parents: Mother's MSD client number ^ Father's MSD client number ^ Disclaimer – The Ministry of Social Development (MSD) will use the birth of child information that you agreed to provide to MSD to determine eligibility to payments and or services. MSD may need to contact you and / or ask for further verification to help them determine this. The Ministry of Social Development includes Work and Income, MSD Housing Assessment, Senior Services, StudyLink and other service lines. The legislation administered by the Ministry of Social Development allows MSD to check the information that you provide. This may happen when you apply for assistance and at any time after that. Signatures (Sign on next page after you print the form). Both parents must sign the form unless: a) One parent is: • Dead • Unknown • Missing • Of unsound mind, or • Unable to act by virtue of a medical condition or b) Requiring the other parent to sign the form would cause unwarranted distress to either of the parents, or c) The other parent is overseas and it is not possible to obtain their signature within a reasonable period of time. Please note: This exception only applies to overseas where there is no delivery address or contact details. d)The child is born as a result of a woman acting alone in an assisted human reproduction procedure and the donor of the ovum, embryo, or semen (as the case may be) for the pregnancy does not become the partner of the woman after the time of conception but before the birth is notified for registration. Note: The donor is generally not the father or other parent. If not sure what details to enter contact us. If any of these circumstances apply, the details of both parents must be entered on the form, except where the other parent is unknown, or where the child was born as a result of the mother acting alone in an assisted human reproduction procedure. If one parent has not signed and their details are entered on this form, if able, you should provide evidence that the other person named is the biological mother/father. That evidence may be a Paternity Order, a Court Declaration, DNA Test Results or statutory declarations from family members. Signatures (Sign after you print the form). I declare that the information entered on this form is true and correct. Signature of Mother. ^ Date. (DD/MM/YYYY) ^ I declare that the information entered on this form is true and correct. Signature of Father. ^ Date. (DD/MM/YYYY) ^ Both parents must sign unless one of the following 8 options applies. We may contact you for more information. (a) One parent is any of the following: Deceased. Yes or No ^ If died in New Zealand provide the date of death, otherwise attach a copy of the death certificate (with an English translation where necessary) to this form. Date of death. (DD/MM/YYYY) ^ Missing. Yes or No ^ If yes, state below what steps you have taken to contact the other parent. Please include whether or not you have contacted the other parents’ friends and family or used social media to locate and contact the other parent. Of unsound mind. Yes or No ^ Provide evidence from a Registered Medical Doctor and attach it to this form. Unable to sign the form by virtue of a medical condition. Yes or No ^ Provide evidence from a Registered Medical Doctor and attach it to this form. (b) Requiring the other parent to sign the form would cause unwarranted distress to either of the parents. Yes or No ^ Please state the nature of the parental circumstances on the page below. (c) The other parent is overseas and it is not possible to obtain their signature within a reasonable period of time. Yes or No ^ Please note: This exception only applies to overseas where there is no delivery address or contact details. State the circumstances below. (d) The child is born as a result of a woman acting alone in an assisted human reproduction procedure and the donor of the ovum, embryo, or semen (as the case may be) for the pregnancy does not become the partner of the woman after the time of conception but before the birth is notified for registration. Yes or No ^ Provide evidence from a Registered Medical Doctor or from a fertility clinic and attach it to this form. (e) None of these. Yes or No ^ Other information you want to advise us, if required. ^ If you have further information attach it to this form. Birth Certificate Order Form. Delivery Address. First name. ^ Surname. ^ Flat number (if applicable). ^ Street number. ^ Street name. ^ Suburb or locality. ^ City/town or district. ^ Postcode. ^ Country (if not NZ). ^ Standard certificates have a plain white background and no additional images. There are two types of decorative certificates available. The forest decorative certificate shows a stream surrounded by native bush, including koru, fern and kowhai. The beach decorative certificate shows a woman sitting with a baby on a beach. The women looks out towards the sea as her family waves back at her. You do not need to purchase a birth certificate if you only require a birth certificate to verify the birth with MSD. Send the following certificates. Standard and Forest. Two certificate package $55.00 Enter quantity ^ Standard and Beach. Two certificate package $55.00 Enter quantity ^ Forest. $35.00 each. Enter quantity ^ Beach. $35.00 each. Enter quantity ^ Standard. $33.00 each. Enter quantity ^ Courier fee (optional). To a New Zealand address $5 Yes or No ^ To an overseas address Yes or No ^ If yes select country and courier costs from the list of 219 countries in Appendix B (below). ^ Total courier fees. ^ I choose the following method to pay for the order: Charge my credit card. Yes or No ^ Visa Yes or No ^ Mastercard Yes or No ^ AMEX Yes or No ^ Prezzy card Yes or No ^ (a) Card Number. ^ (b) Expiry Date. (MM/YY) ^ (c) Cardholder's name. ^ (d) Cardholder's signature. ^ Enter all details online and remember to include payment. Once completed click on this button to Print Form then Sign and Post to: Births Registrations Online, Births, Deaths and Marriages, PO Box 10526, Wellington 6143. Note: Pictorial certificates will be posted flat in an A4 size reinforced envelope. Standard certificates will be folded into a standard DLE envelope with address details printed on the back of the certificate. Appendix A List of 70 hospitals (may not include all hospitals). Ashburton Hospital Ashburton Auckland City Hospital Auckland Birthing Unit Helensville Birthing Unit Huntly Birthing Unit Warkworth Botany Downs Hospital Howick Burwood Birthing Unit Christchurch Charlotte Jean Maternity Hospital Alexandra Christchurch Womens Hospital Christchurch Clutha Health First Balclutha Dannevirke Hospital Dannevirke Elizabeth R Hospital Stratford Gisborne Hospital Gisborne Gore Hospital Gore Greymouth Hospital Greymouth Hawera Hospital Hawera Hawkes Bay Hospital Soldiers' Memorial Hastings Hawkes Bay Regional Hospital Hastings Hutt Hospital Lower Hutt Invercargill Hospital Invercargill Kaikoura Hospital Kaikoura Kaitaia Hospital Kaitaia Kawakawa Hospital Kawakawa Kenepuru Hospital Porirua Levin Hospital Levin Lincoln Hospital Christchurch Masterton Hospital Masterton Matamata Hospital Matamata Matariki Hospital Te Awamutu Middlemore Hospital Otahuhu Morrinsville Hospital Morrinsville Motueka Hospital Motueka Napier Hospital Napier Nelson Hospital Nelson North Shore Hospital Auckland Oamaru Hospital Oamaru Opotiki Hospital Opotiki Palmerston North Hospital Palmerston North Papakura Hospital Papakura Paraparaumu Hospital Paraparaumu Pukekohe Hospital Pukekohe Queen Mary Hospital Dunedin Queenstown Hospital Queenstown Rangiora Hospital Rangiora Rawene Hospital Hokianga River Ridge Birth Centre Hamilton Rotorua Hospital Rotorua Taihape Hospital Taihape Taranaki Base Hospital New Plymouth Taumarunui Hospital Taumarunui Taupo Hospital Taupo Tauranga Hospital Tauranga Te Kuiti Hospital Te Kuiti Te Puia Springs Hospital Te Puia Springs Thames Hospital Thames Timaru Hospital Timaru Tokoroa Hospital Tokoroa Tuatapere Maternity Home Tuatapere Waihi Hospital Waihi Waikato Hospital Hamilton Wairau Hospital Blenheim Wairoa Hospital Wairoa Waitakere Hospital Henderson Wanganui Hospital Whanganui Waterford Birth Centre Hamilton Wellington Hospital Wellington Wellsford Birthing Unit Wellsford Whakatane Hospital Whakatane Whangarei Hospital Whangarei Winton Hospital Winton. Appendix B. List of countries, courier costs, and number of working days to deliver. Afghanistan (2-5 working days) $30.00 Albania (2-5 working days) $30.00 Algeria (2-5 working days) $30.00 American Samoa (2-5 working days) $30.00 Andorra (2-4 working days) $25.00 Angola (2-5 working days) $30.00 Anguilla (2-5 working days) $30.00 Antigua and Barbuda (2-5 working days) $30.00 Argentina (2-5 working days) $30.00 Armenia (2-5 working days) $30.00 Aruba (2-5 working days) $30.00 Australia (2-3 working days) $15.00 Austria (5-6 working days) $25.00 Azerbaijan (2-5 working days) $30.00 Bahamas (2-5 working days) $30.00 Bahrain (2-5 working days) $30.00 Bangladesh (2-5 working days) $15.00 Barbados (2-5 working days) $30.00 Belarus (2-5 working days) $30.00 Belgium (5-6 working days) $25.00 Belize (2-5 working days) $30.00 Benin (2-5 working days) $30.00 Bermuda (2-5 working days) $30.00 Bhutan (2-5 working days) $15.00 Bolivia (2-5 working days) $30.00 Bonaire (Carribean Netherlands) (2-5 working days) $30.00 Bosnia and Herzegovina (2-4 working days) $30.00 Botswana (2-5 working days) $30.00 Brazil (5-6 working days) $30.00 Brunei (2-4 working days) $15.00 Bulgaria (2-4 working days) $30.00 Burkina Faso (2-5 working days) $30.00 Burundi (2-5 working days) $30.00 Cambodia (2-4 working days) $15.00 Cameroon (2-5 working days) $30.00 Canada (5-6 working days) $30.00 Canary Islands, The (2-5 working days) $25.00 Cape Verde (2-5 working days) $30.00 Cayman Islands (2-5 working days) $30.00 Central African Republic (2-5 working days) $30.00 Chad (2-5 working days) $30.00 Chile (2-5 working days) $30.00 China, People's Republic (4-6 working days) $15.00 Colombia (2-5 working days) $30.00 Comoros (2-5 working days) $30.00 Congo (2-5 working days) $30.00 Congo, The Democratic Republic Of (2-5 working days) $30.00 Cook Islands (4-6 working days) $15.00 Costa Rica (5-6 working days) $30.00 Cote D'Ivoire (2-5 working days) $30.00 Croatia (5-6 working days) $30.00 Cuba (2-5 working days) $30.00 Curacao (2-5 working days) $30.00 Cyprus (2-4 working days) $30.00 Czech Republic (5-6 working days) $25.00 Denmark (5-6 working days) $25.00 Djibouti (2-5 working days) $30.00 Dominica (2-5 working days) $30.00 Dominican Republic (2-5 working days) $30.00 East Timor (2-4 working days) $15.00 Ecuador (5-6 working days) $30.00 Egypt (2-5 working days) $30.00 El Salvador (5-6 working days) $30.00 Equatorial Guinea (2-5 working days) $30.00 Eritrea (2-5 working days) $30.00 Estonia (2-4 working days) $25.00 Ethiopia (2-5 working days) $30.00 Falkland Islands (2-5 working days) $25.00 Faroe Islands (2-4 working days) $25.00 Fiji (2-5 working days) $15.00 Finland (5-6 working days) $25.00 France (2-4 working days) $25.00 French Guiana (2-5 working days) $30.00 Gabon (2-5 working days) $30.00 Gambia (2-5 working days) $30.00 Georgia (2-5 working days) $30.00 Germany (5-6 working days) $25.00 Ghana (2-5 working days) $30.00 Gibraltar (2-4 working days) $25.00 Greece (2-4 working days) $30.00 Greenland (2-5 working days) $25.00 Grenada (2-5 working days) $30.00 Guadeloupe (2-5 working days) $30.00 Guam (2-4 working days) $30.00 Guatemala (2-5 working days) $30.00 Guernsey (2-4 working days) $25.00 Guinea (2-5 working days) $30.00 Guinea-Bissau (2-5 working days) $30.00 Guyana (2-5 working days) $30.00 Haiti (2-5 working days) $30.00 Honduras (2-5 working days) $30.00 Hong Kong (4-6 working days) $15.00 Hungary (5-6 working days) $25.00 Iceland (2-4 working days) $25.00 India (2-5 working days) $15.00 Indonesia (2-4 working days) $15.00 Iraq (2-5 working days) $30.00 Ireland, Republic Of (5-6 working days) $25.00 Israel (2-5 working days) $30.00 Italy (5-6 working days) $25.00 Jamaica (2-5 working days) $30.00 Japan (4-6 working days) $15.00 Jersey (2-4 working days) $25.00 Jordan (2-5 working days) $30.00 Kazakhstan (2-5 working days) $30.00 Kenya (2-5 working days) $30.00 Kiribati (2-5 working days) $15.00 Korea, D.P.R. of (North) (2-4 working days) $15.00 Korea, Republic Of (South) (4-6 working days) $15.00 Kuwait (2-5 working days) $30.00 Kyrgyzstan (2-5 working days) $30.00 Laos (2-4 working days) $15.00 Latvia (2-4 working days) $25.00 Lebanon (2-5 working days) $30.00 Lesotho (2-5 working days) $30.00 Liberia (2-5 working days) $30.00 Liechtenstein (2-4 working days) $25.00 Lithuania (2-4 working days) $25.00 Luxembourg (2-4 working days) $25.00 Macau (4-6 working days) $15.00 Macedonia, Former Yugoslav Republic (2-4 working days) $30.00 Madagascar (2-5 working days) $30.00 Malawi (2-5 working days) $30.00 Malaysia (4-6 working days) $15.00 Maldives (2-5 working days) $15.00 Mali (2-5 working days) $30.00 Malta (2-4 working days) $30.00 Marshall Islands (2-4 working days) $30.00 Martinique (2-5 working days) $30.00 Mauritania (2-5 working days) $30.00 Mauritius (2-5 working days) $30.00 Mayotte (2-5 working days) $30.00 Mexico (5-6 working days) $30.00 Moldova, Republic Of (2-5 working days) $30.00 Monaco (2-4 working days) $25.00 Mongolia (2-5 working days) $15.00 Montserrat (2-5 working days) $30.00 Mozambique (2-5 working days) $30.00 Myanmar (2-4 working days) $15.00 Namibia (2-5 working days) $30.00 Nauru, Republic Of (2-5 working days) $15.00 Nepal (2-5 working days) $15.00 Netherlands, The (5-6 working days) $25.00 New Caledonia (2-5 working days) $15.00 Nicaragua (2-5 working days) $30.00 Niger (2-5 working days) $30.00 Nigeria (2-5 working days) $30.00 Niue (2-5 working days) $15.00 Norway (5-6 working days) $25.00 Oman (2-5 working days) $30.00 Panama (2-5 working days) $30.00 Papua New Guinea (2-4 working days) $15.00 Paraguay (2-5 working days) $30.00 Peru (2-5 working days) $30.00 Philippines, The (4-6 working days) $15.00 Poland (5-6 working days) $25.00 Portugal (5-6 working days) $25.00 Puerto Rico (2-5 working days) $30.00 Qatar (2-5 working days) $30.00 Reunion, Island Of (2-5 working days) $30.00 Russian Federation, The (2-5 working days) $30.00 Rwanda (2-5 working days) $30.00 Saipan (Northern Mariana Islands) (2-4 working days) $30.00 Samoa (4-6 working days) $15.00 Sao Tome and Principe (2-5 working days) $30.00 Senegal (2-5 working days) $30.00 Serbia and Montenegro (2-4 working days) $30.00 Seychelles (2-5 working days) $30.00 Sierra Leone (2-5 working days) $30.00 Singapore (4-6 working days) $15.00 Slovakia (2-4 working days) $25.00 Slovenia (5-6 working days) $25.00 Solomon Islands (2-5 working days) $15.00 Somalia (2-5 working days) $30.00 South Africa (2-5 working days) $30.00 Spain (5-6 working days) $25.00 Sri Lanka (2-5 working days) $15.00 St. Barthelemy (2-5 working days) $30.00 St. Kitts-Nevis (2-5 working days) $30.00 St. Lucia (2-5 working days) $30.00 St. Maarten (2-5 working days) $30.00 St. Vincent (2-5 working days) $30.00 Sudan (2-5 working days) $30.00 Suriname (2-5 working days) $30.00 Swaziland (2-5 working days) $30.00 Sweden (5-6 working days) $25.00 Switzerland (5-6 working days) $25.00 Syria (2-5 working days) $30.00 Tahiti (French Polynesia) (2-5 working days) $15.00 Taiwan (4-6 working days) $15.00 Tajikistan (2-5 working days) $30.00 Tanzania (2-5 working days) $30.00 Thailand (4-6 working days) $15.00 Togo (2-5 working days) $30.00 Tonga (4-6 working days) $15.00 Trinidad and Tobago (2-5 working days) $30.00 Tunisia (2-5 working days) $30.00 Turkey (2-5 working days) $30.00 Turks and Caicos Islands (2-5 working days) $30.00 Tuvalu (2-5 working days) $15.00 Uganda (2-5 working days) $30.00 United Arab Emirates (2-5 working days) $30.00 United Kingdom (5-6 working days) $25.00 United States Of America (5-6 working days) $20.00 Uruguay (5-6 working days) $30.00 Uzbekistan (2-5 working days) $30.00 Vanuatu (4-6 working days) $15.00 Venezuela (2-5 working days) $30.00 Vietnam (4-6 working days) $15.00 Virgin Islands (British) (2-5 working days) $30.00 Virgin Islands (US) (2-5 working days) $30.00 Yemen (2-5 working days) $30.00 Zambia (2-5 working days) $30.00 Zimbabwe (2-5 working days) $30.00 Last updated: 2 April 2024.