APP
Form 208

ACT GOVERNMENT
Births, Deaths and Marriages Registration Act 1997
Registrar-General’s Office

APPLICATION FOR A CERTIFICATE

PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH)) 

PRIVACY NOTES
The Births, Deaths and Marriages Registration Act 1997 authorises the Registrar-General to collect the information required by this form in processing your application.  The Registrar-General prevents any unreasonable intrusion into a person’s privacy in accordance with the Privacy Act 1988 (C’wlth).  However, the Registrar-General provides identifiable information to law enforcement organisations and authorised organisations that have the legal authority to request information under prescribed circumstances.	

GENERAL INFORMATION
This form can be used to apply for a birth, death, marriage or change of name certificate for events that have occurred and are registered in the Australian Capital Territory only.  Single status and parentage searches can be also be applied for using this form.  If you are unable to comply with the stated requirements, you will need to contact this office for further assistance.	

COMMITMENT TO SERVICE
For those applications received through the post, we commit to fulfilling your request for a certificate within three working days of receiving your application, providing we have enough information and evidence to establish your entitlement to the certificate.  If you application does not meet our proof of identity requirements we may need you to reapply and provide additional identification and/or more information, either by post or by attending our office.	

REGISTERED PERSON TO PERSON POSTAGE
If you are not applying in person at our office, the certificate will be sent to you by registered person to person post.  As a result you will need to produce appropriate identification at the post office in order to collect the certificate.  Without that identification Australia Post will not allow you to collect the certificate.	

FEES CURRENT TO 30 JUNE 2008
The standard birth certificate fee is $35.00. The commemorative package fee (which includes a standard birth certificate and a commemorative certificate) is $49.00.  If delivered by mail the certificate must be sent by secure registered person to person post and an additional $5.00 fee is payable.  If the certificate is to be sent by overseas mail, a $16.00 international registered post fee will apply.  Payment can be made by cash, credit card, EFTPOS, money order or cheque, all cheques and money orders should be made payable to the Registrar-General.  Applications paid by personal cheque will be held for 7-10 working days for the cheque to clear.	

CONTACT DETAILS
The Registrar-General’s Office is located at 255 Canberra Avenue, Fyshwick ACT 2609.  Our postal address is PO Box 225, Civic Square ACT 2608.  Our office hours are 9:00am to 4:30pm Monday to Friday.  You may also download forms and information from our website at www.rgo.act.gov.au  or contact this office on (02) 6207 0460.	

Telephone Interpreter Services	

If English is not your first language, and you need help with this form, please telephone 131 450 for assistance 24 hours a day.

APP
Form 208

Application No

ACT GOVERNMENT
Births, Deaths and Marriages Registration Act 1997
Registrar-General’s Office
APPLICATION FOR A CERTIFICATE

PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH))

PART A – DETAILS OF APPLICANT	
Surname		Given names	
     		     	
Current residential address		Postal address if different from residential	
     		     	
			
	Postcode			Postcode	
Daytime contact telephone number		E-mail address	Reason certificate needed	
     		     		     	
Relationship to person named on certificate		Signature	
     		     	

PROOF OF IDENTITY REQUIREMENTS – ALL PHOTOCOPIES OF IDENTIFICATION MUST BE CERTIFIED AS TRUE COPIES OF THE ORIGINALS BY EITHER A POLICE OFFICER OR JUSTICE OF THE PEACE 
If you are applying for a birth, death, marriage, change of name certificate, single status or parentage search, there are particular identification requirements necessary for you to either apply for your own certificate or that of another person.	

Your own certificate		You will require 3 forms of identification as described in table A.	
A certificate for your child who is under 18		You will require 3 forms of identification as described in table A.	
A certificate for your child who is over 18		The Privacy Commissioner has advised that a parent does not have an automatic right of access to their child’s birth certificate, once the child has turned 18.  As a result the Registrar-General will only permit access to the certificate where the child consents in writing.  You will require 3 forms of identification as described in table A for you as the applicant, 3 forms of identification as described in table A for the child upon whose behalf you are requesting the certificate, and a letter from the child giving consent that you may apply for the certificate on their behalf. 	
A certificate for another person		You will require 3 forms of identification as described in table A for you as the applicant, 3 forms of identification as described in table A for the person named on the certificate, and a signed letter from the person named on the certificate giving consent that you may apply for the certificate on their behalf.	
A certificate for another person where there is a legal requirement – solicitor, under power of attorney, welfare group, legal guardian		You will require 3 forms of identification as described in table A for you as the applicant and evidence of authority to obtain the certificate which may include the following:
•	Registered Power of Attorney;
•	Court Order; or,
•	Guardianship Order.	

TABLE A – IDENTIFICATION REQUIRED TO BE PROVIDED UPON APPLICATION (OFFICE USE ONLY)
3 forms of current identification must be provided upon application.  At least 1 form of identification from list 1 and 2 other forms of identification from list 1 or 2.  In cases where a person is unable to provide enough forms of indentification please contact this office.	

LIST 1	SIGHTED	NUMBER	LIST 2	SIGHTED	NUMBER	
Australian Driver’s Licence			Medicare Card			
Australian Passport			Credit Card or Store Account Card			
Firearms Licence			Centrelink Card			
Foreign Passport			Department of Veteran’s Affairs Card			
			Security Guard Licence			
			Tertiary Education Institution Identification			

Standard Birth Certificate                Commemorative Package                 Commemorative Certificate Only 
If applying for a commemorative package or certificate please indicate which type:
Canberra          Capital       Bluebell    Year 2000       Clowns    Blue Bunny    Pink Bunny   Teddy Bears        Duck 	

Surname at birth		Given names at birth	
     		     	
Date of birth		Place of birth in the ACT	
     		     	
Mother’s full maiden name 		Mother’s place of birth		Date of birth	
     		     		     	
Father’s/Parent’s full maiden name		Father’s/parent’s place of birth		Date of birth	
     		     		     	

Standard Marriage Certificate             Commemorative Package              Commemorative Certificate Only 	

Surname of groom at time of marriage		Given names of groom at time of marriage	
     		     	
Surname of bride at time of marriage		Given names of bride at time of marriage	
     		     	
Date of marriage		Place of marriage in the ACT	
     		     	
Full maiden name of groom’s mother		Full maiden name of groom’s father/parent	
     		     	
Full maiden name of bride’s mother		Full maiden name of bride’s father/parent	
     		     	

Death Certificate 	

Surname of deceased		Given names of deceased	
     		     	
Date of death		Place of death in the ACT	
     		     	
Full maiden name of deceased’s mother		Place of birth of deceased’s mother		Date of birth	
     		     		     	
Full maiden name of deceased’s father/parent		Place of birth of deceased’s father/parent		Date of birth	
     		     		     	

Change of Name Certificate                    Parentage Search Certificate                         Single Status Search 	

Full name at birth		Current full name	
     		     	
Date of birth		Place of birth	
     		     	

PART C – PAYMENT DETAILS	

If you are applying by mail and payment is by credit card please complete the details below.  Payment may be made by cash, credit card, EFTPOS, money order or cheque, all cheques and money orders should be made payable to the Registrar-General.  Applications paid by personal cheque will be held for 7-10 working days for the cheque to clear.	

 Mastercard	 Visa Card	Amount	$	
																						
Card Number																					Expiry Date	   __ __ /  __ __	
	
Name of Cardholder		Signature of Cardholder