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Te Tari Taiwhenua Internal Affairs 

BDM65
Application to Deposit a Family Court Declaration as to sex

To apply:
• your birth must be registered in New Zealand, and
• the Family Court must have issued a declaration that your birth certificate should 
contain the information that you are a person of a nominated sex.

To complete the application the following must be sent to Births, Deaths and Marriages:
1. This completed application form (BDM65).
2. The Registrar-General has agreed not to charge fees for this service.
3. If you require a new birth certificate, complete Section 5.
4. If you require an official letter that links your previous birth registration details with 
your new birth registration details request this in Section 6.

Note: 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 Births, Deaths, Marriages, and Relationships Registration Act 1995.

Privacy Statement

The information on this form is collected under the Birth, Deaths and Marriages, 
and Relationships Registration Act 1995. As part of processing your request, your 
indentification details will be checked againist other records held by Birth, Deaths and 
Marriages or other government agencies, as authorised by law.

Post to:
Births, Deaths and Marriages 
PO Box 10526
Wellington 6143

If you have questions:
Call free 0800 22 52 52
Email crs@dia.govt.nz

SECTION 1: Person whose sex is to be recorded (Details currently recorded on New Zealand birth record)

First name(s) ^
Surname ^
First name(s) at birth (If different from above) ^
Surname at birth (If different from above) ^
Date of birth (dd/mm/yyyy) ^
Place of birth ^

Sex currently recorded:
Male Yes or No ^
Female Yes or No ^
Indeterminate Yes or No ^

SECTION 2: Details of attached Family Court Declaration as to sex

Name you wish to appear on future birth certificates:
First name(s) ^
Surname ^

The Family Court has declared that future birth certificates should show sex as:
Male Yes or No ^
Female Yes or No ^
Indeterminate Yes or No ^

SECTION 3: Your contact details

Full name ^
Address ^
Flat/street number and name ^
Suburb ^
Town/city ^
Postcode ^
Country ^
Email Address ^
Phone number ^

SECTION 4: Signature

Select one of these two options:
I am the subject of the information and I wish the information about my nominated sex in the 
Family Court declaration be recorded on my New Zealand birth record. Yes or No ^
I am a guardian of the subject of the information and I wish the information about their 
nominated sex in the Family Court declaration be recorded on their New Zealand birth record. Yes or No ^

Sign here ^

Date signed (dd/mm/yyyy) ^

SECTION 5: Birth certificate order

I request a (select one): 
Standard birth certificate Yes or No ^
Forest style decorative certificate Yes or No ^
Beach style decorative certificate Yes or No ^
All Blacks style decorative certificate Yes or No ^

Send it to me by (select one): 
Post Yes or No ^
Courier Yes or No ^

Delivery Address if different from section 3, if ordering a certificate:
Delivery name ^
Flat/street number and name ^
Suburb ^
Town/city ^
Country ^
Postcode ^

SECTION 6: Letter to confirm previous and new birth registration details

In some circumstances you may require a document that links your previous registration details to your 
new registration details. 

Indicate below if you would like an official letter confirming these details:
Provide a letter confirming these details Yes or No ^
I do not require a letter Yes or No ^

Version 11/2020