ANM
Form 203

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

APPLICATION TO NOTE MARRIAGE DETAILS

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 include details of the marriage of the parents of a child in the register of births, after a child’s birth has been registered.  If the marriage did not occur in the Australian Capital Territory the registered marriage certificate is required.  Both parents must also provide 3 forms of identification.   If you wish to order a new birth certificate after the marriage details have been updated please complete an application for certificate form.  If you wish to change the child’s name after the marriage details have been updated, please complete an application to register a change of name for a child form.  	

FEES CURRENT TO 30 JUNE 2007

There is no fee to lodge an application to note marriage details, however a fee does apply if a new birth certificate is required after the birth register is updated.  Application fees also apply for the registration of a change of name.	

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 8:30am 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.	

WITNESSES TO SIGNATURES AND CERTIFIED COPIES OF DOCUMENTS

If you are lodging this application in person you must supply original identification documents.  If sending your application by post you must have the identification documents certified as true copies of the original documents by a Justice of the Peace, Solicitor or Police Officer.  If you are lodging this application in person all signatures may be witnessed by Births, Deaths and Marriages staff within the Registrar-General’s Office.  If you are sending your application by post all signatures must be witnessed by a Justice of the Peace, Solicitor or Police Officer. 	

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.

Registration No

ANM
Form 203

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

APPLICATION TO NOTE MARRIAGE DETAILS
PART A – DETAILS OF CHILD AT TIME OF BIRTH	
Surname 		Given names	
     		     	
Date of birth		Place of birth	
     		     	

PART B – DETAILS OF MARRIAGE	
Date of marriage		Place of marriage	
     		     	

PART C – DECLARATION BY MOTHER	
I, 	                                                                                                             being a (occupation)	
of (address)		Postcode	
hereby apply to the Registrar-General to include details of the marriage described in part B of this form on the birth registration of the child described in part A of this form, and solemnly and sincerely declare that the statements made in this application are true and correct by virtue of the Statutory Declarations Act 1959 and are subject to penalties provided by that Act for making false statements.	
Declared at (suburb/town)		State/Territory	
     		     	
Applicant’s signature	Dated on	
     		     	
Before me (signature of witness)		Qualification of witness (JP, Solicitor, Police Officer or BDM Staff)	
     		     	
Telephone contact of witness		Full name of witness	
     		     	
Address of witness	
     	

PART C – DECLARATION BY FATHER	
I, 	                                                                                                             being a (occupation)	
of (address)		Postcode	
hereby apply to the Registrar-General to include details of the marriage described in part B of this form on the birth registration of the child described in part A of this form, and solemnly and sincerely declare that the statements made in this application are true and correct by virtue of the Statutory Declarations Act 1959 and are subject to penalties provided by that Act for making false statements.	
Declared at (suburb/town)		State/Territory	
     		     	
Applicant’s signature	Dated on	
     		     	
Before me (signature of witness)		Qualification of witness (JP, Solicitor, Police Officer or BDM Staff)	
     		     	
Telephone contact of witness		Full name of witness	
     		     	
Address of witness