*** 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 BDM133 Request to Search Access Register Notes. Access Register. The access register records who has applied to access birth, marriage, civil union, and name change records on or after 25 January 2009. From 15 June 2023, death records are also included in the access register. Generally, every request for recent information is recorded in the access register. You may obtain a report from the access register of access requests relating to: Your own birth, marriage, civil union or name change records; or Another person’s birth, marriage, civil union or name change records, if you are the person’s personal representative (see below). The access register contains: The name of the applicant; The date the applicant made the request to access the records; and Whether or not the request for access was granted. If an individual applied on behalf of a company or organisation for access to the records, the organisation’s name will appear in the access register as the applicant. The access register does not include details of access granted to: Public sector agencies for maintenance of the law purposes; Authorised public sector agencies receiving information for information matching programmes; Authorised researchers (demographic, historical, statistical or health); Older historical information. There is currently no fee to request a report from the access register. Personal Representative. A “personal representative” means: A parent or guardian of a person, if that person has not attained the age of 18 years and has not earlier married nor entered into a civil union or de facto relationship; or A person who has been granted a power of attorney or has been given written authority by a person, if that person has attained the age of 18 years or has earlier married or entered into a civil union or de facto relationship; or If the person is deceased, the executor, administrator, or trustee of the deceased person’s estate. Documents the personal representative must provide (if applicable): If the personal representative is a parent or guardian of the subject of the record and; The parent is named in the subject’s birth information registered in New Zealand — State this in a signed letter. The parent is named in the subject’s birth information registered outside New Zealand — Provide a certified true copy of the child’s birth certificate, which must name the parents (include a translation if not in English). Was appointed as a Testamentary guardian by a deceased parent under section 26(2) of the Care of Children Act 2004 or section 7(2) of the Guardianship Act 1968 - Provide a certified true copy of the deed or will. Is a Court appointed/approved guardian - Provide a certified true copy of the Court appointment/approval. If the personal representative has been granted a power of attorney or has been given written authority by the subject of the record, attach a certified true copy of the: Power of attorney; or Written authority. To Contact Us. Visit our website www.bdm.govt.nz Freephone 0800 22 52 52 (New Zealand only). If overseas phone + 64 9 339 0852 Email bdm.nz@dia.govt.nz Post this completed and signed form, with attachments to: Births, Deaths and Marriages P O Box 10-526 Wellington 6140 New Zealand Internal Affairs Te Tari Taiwhenua BDM133 Request to Search Access Register. Attach General Identity Declaration form (BDM 130). Please print clearly. Please initial any alterations. Applicant to Complete and Sign. Applicant’s Full Name. First or given names ^ Surname or family name ^ Delivery Name and Address. Addressee ^ Flat number, street number and name ^ Suburb or rural locality ^ City or town ^ Postcode ^ Country (if not New Zealand) ^ Entitlement. I am entitled to request this search of the Access Register because: I am the subject of birth, marriage, civil union and/or name change information. Yes or No ^ I am the personal representative of the person who is the subject of the birth, marriage, civil union and/or name change information (Refer to Notes above). Yes or No ^ Attach documentation (as required). A General Identity Declaration form (BDM130) must be fully completed, signed and attached to this form. If you are the subject’s personal representative you are required to provide additional documentation - Refer to Notes above. Applicant’s Signature ^ Date (DD/MM/YYYY) ^ Applicant’s email address ^ Applicant's daytime mobile or phone number ^ Details of Subject of Access Register Search. I request a search of the Access Register on access to the following information registered in New Zealand: Birth Yes or No ^ Death Yes or No ^ Marriage Yes or No ^ Civil Union Yes or No ^ Name Change Yes or No ^ Subject’s full name. First or given names ^ Surname or family name ^ Subject's Full Name at Birth (if different from above). First or given names ^ Surname or family name ^ Subject's date of birth. Date (DD/MM/YYYY) ^ Subject's place of birth. City or town ^ Country (if not New Zealand) ^ If death, date of death. Date (DD/MM/YYYY) ^ Place of death. If marriage or civil union, date of marriage or civil union. Date (DD/MM/YYYY) ^ Place of marriage or civil union. City or town ^ Marriage or civil union partner’s full name. First or given names ^ Surname or family name ^ Privacy Statement. The information on this form is collected under the Births, Deaths, Marriages, and Relationships Registration Act 2021. As part of processing your request, your identification details will be checked against other records held by Births, Deaths, Marriages and Citizenship or other government agencies, as authorised by law. BDM130 General identity declaration. Reference number, if known ^ Warning: It is an offence, punishable by imprisonment and/or a fine of up to $10,000, to make a false statement to obtain a certificate, printout or a source document, or to provide any means of identification knowing that it is false or is suspected to be forged or falsified. It is an offence to make any statement that is false for the purpose of the recording information under the Births, Deaths, Marriages, and Relationships Registration Act 2021. Instructions. If you have any questions please contact us. Within New Zealand Freephone 0800 22 52 52 Outside New Zealand phone +64 9 339 0852 1. The applicant must fully complete both Parts A and B 2. Part C must be completed by any other person 16 years of age or older Part A. My Details (as the applicant). Current name. Surname ^ First names ^ Name at birth (if different from above). Surname at birth (if different from above) ^ First names at birth (if different from above) ^ Place and date of birth. Place of birth (town or city) including country if not New Zealand ^ Date of birth (DD/MM/YYYY) ^ Your daytime phone number (daytime) ^ Your email address ^ Part B. My declaration (the applicant must complete) I declare that the information about me that is entered on this form is true and correct. Signature ^ Date signed (DD/MM/YYYY) ^ If applying on behalf of a company state their name below and include an original signed request on letterhead. ^ Your details or the company name will be entered in the Access Register. For information about the Access Register visit www.bdm.govt.nz. Part C. Referee’s declaration (any other person 16 years of age or older must complete). I am 16 years of age or older and have known the applicant for at least 6 months or have seen a government issued photo identification of the applicant and I am satisfied the information about the applicant’s identity stated in this form is true and correct. Signature of referee ^ Date signed (DD/MM/YYYY) ^ Full name of referee ^ Phone number of referee ^ Contact address of referee ^ Privacy Statement. The information on this form is collected under the Births, Deaths, Marriages, and Relationships Registration Act 2021. As part of processing your request, your identification details will be checked against other records held by Births, Deaths, Marriages and Citizenship or other government agencies, as authorised by law. Last updated 15 June 2023.