Applicant Details

Your application reference

Email address *

Date of death *

Details of the deceased

Please provide the deceased's name exactly as it should appear on the certificate.

First and middle names *

Surname or family name *

Applicant's details (you, the requester)

Your first and middle names *

Your surname or family name *

Your date of birth *

/ /

Identity confirmation - select one

I was born in New Zealand (easiest method)

I got married or had a civil union in New Zealand

I legally changed my name in New Zealand

My child was born in New Zealand

None of the above apply to me

Your birth evidence

We already have your date of birth above - we just need your place of birth to confirm your identity.

Your place of birth (town/city) *

Your marriage or civil union evidence

Used only to confirm your identity.

Your partner's first and middle names *

Your partner's surname *

Date of marriage (dd/mm/yyyy) *

Place of marriage *

Your name change evidence

Tell us the name you were given at birth, before it was legally changed.

Your first and middle names at birth *

Your surname at birth *

Your country of birth *

Year you changed your name *

Your child's birth evidence

Used only to confirm your identity as the registered parent.

Your child's first and middle names *

Your child's surname *

Your child's date of birth (dd/mm/yyyy) *

Your child's place of birth *

Delivery details

Name for delivery *

Contact phone number *

Do you want courier delivery (faster, additional cost) instead of standard post? *

Yes

No

Unit / house number and street *

Town or city *

Postcode *

Country *