Birth Certificate Application Form

Certificates NZ » Birth Certificate » Order Form

Birth Certificate – Application Form

"*" indicates required fields

Step 1 of 4

· If you want to order a certificate for a historical birth (more than 100 years ago, or more than 50 years ago for stillbirths), you need to visit BDM Online.
· If the birth took place overseas you need to order your certificate from that country. We will only issue certificates to people whose birthplace is New Zealand.

Details of the person who was born

First and middle names (at the time of birth)*

Surname or family names (at the time of birth)*

Date of birth*

Place of birth

Untitled

This is my own birth certificate

Parent’s details (Optional)

Providing this information may help us to find the birth record.

Parent’s first and middle names

Parent’s surname or family names

Other parent’s first and middle names

Other parent’s surname or family names

Your details

As the person ordering the certificate, you need to provide some basic information about yourself so we know who is requesting the record. Your name will then be recorded in the access register. (Learn more about the access register here)

Your first and middle names*

Your surname or family names*

Your IRD Number*

Your date of birth*

Select one of the statements below:*

I was born in New Zealand

I got married or had a civil union in New Zealand

My child was born in New Zealand

None of the above apply to me

Unfortunately you can’t order using this online service. Ask a relative or friend to request the certificate on your behalf.

Was your name different at birth?*

Yes

Your first and middle names (at the time of birth)*

Your surname or family names (at the time of birth)*

Your place of birth*

Your partner’s first and middle names (before the marriage or civil union)*

Your partner’s surname or family name (before the marriage or civil union)*

Place of the marriage or civil union

Date of the marriage or civil union*

Your child’s first and middle names*

Your child’s surname or family name*

Your child's place of birth

Your child's date of birth*

Delivery and contact details

Enter your delivery and contact details below. If we have any issues with your order we will contact you via phone, email or post.

Name for delivery*

Your contact phone number

Email*

Enter Email Confirm Email

Address*

Enter unit/house number and street Enter suburb or any other appropriate description City or town State / Province / Region Postcode Country

Certificate type:	Birth Certificate
Delivery time:	1–2 weeks
Total	NZ$95.00