BIRTHS, DEATHS AND MARRIAGES
OFFICE OF REGULATORY SERVICES
Department of Justice and Community Safety

WCP
Form 221

NOTICE OF WITHDRAWAL OF TERMINATION OF A 
CIVIL PARTNERSHIP

Civil Partnerships Act 2008
Births, Deaths and Marriages Registration Act 1997
Births, Deaths and Marriages Registration Regulation 1998

Registration Number 
(office use only)

IMPORTANT INFORMATION
Applicants should be aware of their responsibilities under the Civil Partnerships Act 2008.   You can view the legislation and its regulations or download them from www.legislation.act.gov.au.  You may also obtain information and relevant forms at www.ors.act.gov.au.  The Civil Partnerships Act 2008 and the Births, Deaths and Marriages Registration Act 1997 authorise 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 authorized organisations that have the legal authority to request information under prescribed circumstances.

Send completed applications to the Office of Regulatory Services:  	GPO BOX 158, CANBERRA   ACT   2601
Or provide in person at:						255 Canberra Avenue, Fyshwick.
Or call for assistance on:						02 6207 0460

GENERAL INFORMATION
A civil partnership is terminated upon the death or marriage of either party.  A civil partnership may also be terminated by the lodgment of a Notice to Terminate a Civil Partnership or by application to the Supreme Court.  If you wish to terminate a civil partnership by order of the Supreme Court you should seek independent legal advice or contact the Supreme Court.  

This form is to be used in accordance with section 10 of the Civil Partnerships Act 2008 (the Act), to give notice to the Registrar-General of the intention to withdraw a notice to terminate a civil partnership.   A notice to terminate a civil partnership may only be withdrawn by the party, or parties, who gave the termination notice, before the end of 12 months after the day the termination notice was given to the Registrar-General.  

If the notice is given to the Registrar-General by only 1 party it is effective only if:

•	a copy of the notice has been served personally on the other party; and,
•	the attached statutory declaration is completed by the person who served the withdrawal of termination notice including the date on which it was served.

To serve this notice personally on a party, the person serving the notice must:

•	give the party a copy of the notice;
•	if the party does not accept  the notice, put the copy down in the party’s presence and tell the party in general terms what it is; or
•	if the person serving the notice is prevented from approaching the party by violence or threat of violence, put the copy down as near as practicable to, but in the sight of, the party.

Please note 3 forms of current identification must be provided upon lodgement of this form.  If lodged by both parties, each person must provide 3 forms of current identification.   

 

PARTICULARS OF CIVIL PARTNERSHIP	

REGISTRATION NUMBER	     	
	PARTNER 1	PARTNER 2	
Surname
(as written on your POI document)	     	     	
Given names
(as written on your POI document)	     	     	
Usual place of residence	     	     	
Place of birth 
(insert city/town, Australian State or Territory, or if born overseas, city/town and country)	     	     	
Date of birth	     	     	
Mother’s surname	     	     	
Mother’s full given names	     	     	
Father’s/
Parent’s surname	     	     	
Father’s/
Parent’s full given names	     	     	

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)

STATUTORY DECLARATION BY CIVIL PARTNER/S TO WITHDRAW NOTICE OF TERMINATION OF CIVIL PARTNERSHIP	

PARTNER 1	PARTNER 2	

I,				________________

of 				________________

hereby solemnly declare that I wish to terminate the civil partnership with

					__________

Signature ________________________________

I,				________________

of 				________________

hereby solemnly declare that I wish to terminate the civil partnership with

					__________

Signature ________________________________
	
Declared at ______________________________ Canberra, ACT on _____________________________

Before me _______________________________ Qualification of witness ________________________ 	

STATUTORY DECLARATION BY PERSON SERVING NOTICE OF WITHDRAWAL OF TERMINATION OF CIVIL PARTNERSHIP	

I,________________________________________ of _________________________________________

hereby solemnly declare that I have served a copy of this notice in accordance with sections 10 and 14

of the Civil Partnerships Act 2008 on ________________________________________

Signature ____________________________________________________

Declared at ______________________________ Canberra, ACT on _____________________________

Before me _______________________________ Qualification of witness ________________________