*** 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. *** Internal Affairs Te Tari Taiwhenua BDM120 Application to register a name change | He tono ki te rēhita i tētahi panoni ingoa Use this form to register a name change if: • you are aged 18 or older, or • you are aged 16 or 17 and are, or have been, in a marriage, a civil union, or de facto relationship. Before you apply Who can register a name change To register a name change in New Zealand: • your birth must be registered in New Zealand, or • if your birth is registered outside New Zealand, you must be a New Zealand citizen or entitled, under the Immigration Act 2009, to be in New Zealand indefinitely (for example, as a permanent resident). Guidelines for your new name Your new name must consist of one surname and one or more other names. If your religious or philosophical beliefs, or cultural traditions require you 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) Timeframe To view our current timeframes, go to govt.nz/bdmtimeframes. Allow extra time for postage. If you have requested a certificate showing your new name, it will be sent by post or courier after the name change is processed. Contact details Website: govt.nz/bdm/contactus Email: bdm.nz@dia.govt.nz Only use email for queries about the form. To return the form, follow the postage instructions on page 13. 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. include supporting documents, and 2. make a statutory declaration. Refer to below for further information about these requirements. 1. Documents to attach Include an official English translation of any document that is not in the English language. There are 3 types of documents: • List 1 - Your eligibility to register a name change in New Zealand • List 2 - Your current photo identification • List 3 - Proof of the use of your identity in the community. If your birth is registered in New Zealand: you must provide documents from Lists 2 and 3. If your birth is registered overseas: you must provide documents from Lists 1, 2 and 3. Contact us if you cannot meet these requirements. List 1: Your eligibility to apply to register a name change in New Zealand If your birth is registered in New Zealand go directly to List 2. If your birth is registered outside New Zealand you must provide evidence of: • the date and place of your birth, and • your status as a New Zealand citizen or entitled, under the Immigration Act 2009, to be in New Zealand indefinitely (for example, as a permanent resident). Provide a certified true copy of one (or combination if applicable) of the following documents: • New Zealand citizenship certificate • New Zealand passport (photo page only) • New Zealand certificate of identity issued under the Passports Act 1992 with a letter/permit/visa from Immigration New Zealand confirming permanent resident status • Australian passport or other evidence of Australian citizenship • Cook Islands, Niue or Tokelau Birth Certificate • Overseas passport including a resident permit or resident visa issued by Immigration New Zealand • Letter from Immigration New Zealand confirming permanent residence status (only if the letter states your name, date of birth, place of birth and name(s) of parent(s) • Overseas birth certificate together with a letter/permit/visa from Immigration New Zealand confirming permanent residence status • Notarial certificate (China) that includes names of parent(s) together with a letter/permit/visa from Immigration New Zealand confirming permanent residence status • Household/Family census register that includes names of parent(s) from an Asian country together with a letter⁄ permit/visa from Immigration New Zealand confirming permanent residence status List 2: Your current photo identification You must provide a certified true copy of one of the following. It must include your photo. If you are providing a document from List 1 that has your photo on it go directly to List 3. • 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 police service photo identity 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 • Overseas identity card • 18+ card or Kiwi Access Card (issued by Hospitality New Zealand) or overseas proof of age card 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 your photo identification has expired, it must have expired within the last 2 years. 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/name-change-adult. 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. List 3: Proof of the use of your identity in the community You must provide copies of 2 different documents that show either your birth name, married name or new name. These do not need to be certified. If possible, these documents should show the same name as shown on your photo identification. If you don’t have documents showing the same name, send what you have and we will contact you if we need more information. Accepted documents include: • 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) • Confirmation of permit status from Immigration New Zealand • Certificate of Approval or licence issued by the Private Security Personnel Licencing Authority 2. Statutory declaration requirements A statutory declaration is a written statement signed in front of an authorised person and declared to be true. The people following people are authorised to take a statutory declaration. In 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 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 on the next page) Non-Commonwealth country • Commonwealth representative • Notary public • Judge • Solicitor of the High Court of New Zealand 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 Australian Police are not authorised to take this statutory declaration unless you are in the Northern Territory. Australian pharmacists, optometrists and doctors are not authorised to take this statutory declaration. • 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 South Australia • Commissioner for Affidavits Also, if in Western Australia • A mining registrar appointed under the Mining Act 1978 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 England or Wales • Judge • Commissioner 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 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 may also release it to certain government agencies and foreign registration authorities, as authorised by law. 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. The information collected in your application may be used in statistical analysis and reporting for service improvement and business management purposes. Personal information will only be used where necessary for those purposes. Data is stored, accessed and retained in accordance with our Privacy Policy, Information Management Policy, and the DIA Code of Conduct which incorporates our ICT and security policies, and in compliance with the Privacy Act 2020 and the Public Records Act 2005. 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. • 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 old name 1a. Name at birth This is the name on your birth certificate. If legally adopted, enter the names you were given after adoption. All first and middle names ^ Surname ^ 1b. Name from previously registered name change (if applicable) This applies if your current name is different from your name at birth due to a registered name change. It does not apply if you have assumed a surname on marriage or civil union, even if that surname was included on your passport. All first and middle names ^ Surname ^ 2. My date of birth Date (dd/mm/yyyy) ^ 3. My place of birth Town or city of birth ^ Country of birth (if not New Zealand) ^ Indicate which documents you have attached (refer to the lists at the start of this form): Select one: My birth is registered in New Zealand, so I have attached documents from Lists Yes or No ^ My birth is registered outside New Zealand, so I have attached documents from Lists 1, 2 and 3 Yes or No ^ 4. My contact details Phone number ^ Email ^ 5. Return of documents Indicate whether you want your attached documents to be: Select one: Securely destroyed Yes or No ^ Returned to you Yes or No ^ 6. (If 16 or 17 years of age) I am, or have been, in a: Select one: Marriage Yes or No ^ (Fill in date and place fields below) Civil union Yes or No ^ (Fill in date and place fields below) De facto relationship Yes or No ^ Date of marriage or civil union (dd/mm/yyyy) ^ Place of marriage or civil union ^ Statutory declaration 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. 7. I, (Enter the name you are currently known by.) Full name ^ 8. of (Enter your residential address. This cannot be a PO Box.) Street number and name ^ Suburb ^ Town or city ^ Country ^ 9a. Enter your occupation. For example, ‘Landscape gardener’ or ‘Home-maker’. If you have no occupation, enter ‘No occupation’. Occupation ^ I solemnly and sincerely 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 this name change application. My authorisation includes any information held by the Department of Internal Affairs or another NZ government agency. 10. The name I want to register is: Refer to the ‘Guidelines for your new name’ at the start of this form. All first and middle names of new name ^ Surname of new name ^ If you are married or in a civil union Surname assumed through marriage or civil union Generally, you do not need to register the surname you assumed through your marriage or civil union. This is because organisations may acknowledge your new surname using some other evidence. For example, your marriage certificate. You also cannot register if you change back from using your assumed surname to using your birth surname. Only changing your first name(s) If you are married or in a civil union and only want to change your first name(s), enter the surname of your new name as it is currently recorded on your birth registration. Do not print the surname you assumed through marriage. 11. I advise that I intend to use my new name once my name is registered Yes or No ^ If you are already using your new name select this option. 12. Fill out and sign this section before a person authorised to take a statutory declaration (Refer to the start of this form for the list of authorised people.) 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 if not in New Zealand) ^ this day of (dd/mm/yyyy) ^ by (Signature of applicant) ^ 13. The person authorised to take a statutory declaration must complete this section. They must also certify a true copy of the applicant’s original photo identification document from the list on page 2. 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 start of this form (write document name and number below). Yes or No ^ If the photo identification has expired, it must have expired within the last 2 years. Document name (e.g. New Zealand passport) ^ Document number (e.g. Passport number) ^ I have sighted the applicant’s photo on a fully completed BDM76 Identity Referee form. Yes or No ^ Signature (Authorised person signs here) ^ Full name of authorised person ^ Qualification of authorised person ^ End of Statutory Declaration. Continue to sections 14-20 of the form. 14. Human Assisted Reproductive Technology Register (HART) Are you a donor or person born as a result of a HART procedure? Yes ^ Fill in this section. No ^ Go to Section 15. This section applies if you were 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 new name. This means that up-to-date information will be provided to persons who are authorised to access your information under the Human Assisted Reproductive Technology Act 2004. Donation made after 21 August 2004 If your birth occurred 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 new name being sent to the fertility clinic named below that holds the information: Fertility clinic name ^ 15. Fees The application fee to register a name change is $170. 16. Name change certificate (additional fee) You can order a name change certificate if: • your birth is registered outside New Zealand, and • you need a certificate that shows your new name. If you do not need a certificate to prove your new name, this is optional. Name change certificate. $33 each. Quantity wanted? ^ 17. Birth certificate (additional fee) You can order a birth certificate if your birth is registered in New Zealand and you need a certificate that shows your new details. If you do not need a certificate to prove your new sex marker or name, this is optional. There are several types and packages of birth certificate that you can select from. Standard certificate. $33 each. Quantity wanted? ^ Forest style decorative certificate. $35 each. Quantity wanted? ^ Beach style decorative certificate. $35 each. Quantity wanted? ^ Two certificate package: beach style decorative and one standard. $55 per package. Quantity wanted? ^ Two certificate package: forest style decorative and standard. $55 per package. Quantity wanted? ^ 18. Note your new name on your New Zealand marriage or civil union record (additional fee) You can have your new name noted on your marriage or civil union if: • you are currently married or in a civil union, and • your marriage or civil union is registered in New Zealand. This will cost $55. You can also order a marriage or civil union certificate. This will cost $33. Select the options that apply: I want my new name noted on my New Zealand marriage or civil union ($55) Yes or No ^ I would like to order a new marriage or civil union certificate after my new name is noted on my New Zealand registered marriage or civil union ($33) Yes or No ^ Details of your most recent marriage or civil union: Marriage Yes or No ^ Civil union Yes or No ^ Date of marriage or civil union (dd/mm/yyyy) ^ Place of marriage or civil union ^ 19. Delivery of name change, birth or marriage/civil union certificate (if applicable) If you have ordered a certificate, select a delivery method: I want the certificate(s) sent by standard post, which costs $0 Yes or No ^ I want the certificate(s) couriered to a New Zealand address for $5 Yes or No ^ I want the certificate(s) couriered to an overseas address for $15 to $30 Yes or No ^ Australia, Asia, Pacific courier costs $15. USA courier costs $20. Rest of world (includes: Azerbaijan, Armenia, Bulgaria, Bosnia and Herzegovina, Cyprus, Croatia, Greece, Georgia, Macedonia, Malta, Moldova) costs $30. Contact us if you are unsure whether we can deliver to your country. Delivery address: Delivery name ^ Street number and name ^ City, town or district ^ Postcode ^ Country (if not New Zealand) ^ 20. Payment Do not post cash or card. Do not email credit card details. Charge my debit or credit card (Visa, MasterCard, American Express, Prezzy Card): 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. ^ Next steps Print and sign the form. 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 Last updated 16 June 2025.