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BDM93B  

He tono mō tētahi Tiwhikete Whānautanga o Aotearoa, Tānga rānei 
Request for New Zealand Birth Certificate or Copy of Record 

Version: 02 April 2024 

If you are ordering a certificate for your new baby you must register their birth first. Register your child and order a certificate at the same time at https://smartstart.services.govt.nz 

To order certificates online visit www.govt.nz/bdm 

If you intend to use the certificate overseas refer to www.govt.nz/authentications
 
SECTION 1: Certificate details 

First and middle names (required) ^
Surname or family names (required) ^
Date of birth (required) ^
Town or city of birth ^
Parent 1 full names ^
Parent 2 full names ^
Other information (e.g. folio number) ^

SECTION 2: Delivery address and contact details 

Delivery name ^
Flat no ^
Street no ^
Street name ^
Suburb or rural locality ^
City, town or district ^
Postcode ^
Country (if not New Zealand) ^

Applicant's contact phone number ^
Applicant's email address ^

SECTION 3: Certificate style and quantity 

Enter quantity
Price 
The certificate will be sent folded with the delivery address printed on the back. 
Standard birth certificate $33 ^
Forest style decorative certificate $35 ^
Beach style decorative certificate $35 ^
Value pack: Forest style decorative + standard certificate $55 ^
Value pack: Beach style decorative + standard certificate $55 ^
Copy of the Record $25
This is a copy of the birth record usually used for genealogical research and is not a legal document. It may be typed or handwritten. ^
If the record cannot be found we will contact you and search fees will apply. 

SECTION 4: Delivery method and payment 

I want the certificate(s) sent by standard post $0 ^
I want the certificate(s) or copy of the record couriered to a New Zealand address $5 ^
I want the certificate(s) or copy of the record couriered to an overseas address ^
Australia, Asia, Pacific $15
USA $20 
Europe $25 
Rest of the world $30 
I am ordering a copy of the record and want it emailed $0 ^
I am ordering a copy of the record and want it sent by standard post $0 ^

Complete payment details on last page attached to this form. 

Sections 5 and 6 on the next page are not required if the birth certificate you are ordering is more than 100 years old, or was a still-birth more than 50 years ago. 

SECTION 5: Proof of identity 

We check your details in this form against another identity record 
Choose one of the following to confirm your identity 
I was born in New Zealand ^
I am ordering my child's birth certificate ^
I am ordering my own birth certificate ^
I was married or entered into a civil union in New Zealand ^ 
Date of marriage or civil union  ^
Town or city of marriage or civil union ^
My child was born in New Zealand ^
Child's date of birth ^
Child's full name ^

OR include a photocopy of one of the following identity documents: ^
-Passport (NZ or overseas) 
-Driver Licence (NZ or overseas) 
-Kiwi Access Card (issued by Hospitality NZ) 
-18+ Card (issued by Hospitality NZ) 
-NZ Firearms or Dealer’s Licence 
-Salvation Army identity certification 
-NZ Refugee Travel Document 
-NZ Emergency Travel Document 
-NZ Certificate of Identity (Issued by Immigration NZ) 
-NZ Certificate of Identity (Issued under the Passport Act 1992) 
-Steps to Freedom document (issued by Department of Corrections) 

Do not send the original 

SECTION 6: Declaration 

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

I am ordering on behalf of a company, and have included a signed request on company letterhead 

I declare that the information above is true and correct. I understand that any person who makes a false statement will be liable on conviction to a fine or imprisonment, or both. I understand the information on this form is collected 
under the Births, Deaths, Marriages, and Relationships Registration Act 2021. As part of processing my request, I understand that my identification details will be checked against other records held by the Department of Internal Affairs or other government agencies, as authorised by law. I understand that my name will be recorded on the access register for any non-historical certificates that I order. 

My signature ^
Date signed ^

Office Use Only B D
Submit your form and payment 

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

In person
Visit www.govt.nz/bdmoffices for the location of offices in Auckland, Wellington, Christchurch, Sydney and London

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