BDM1
Registry of Births, Deaths and Marriages, Western Australia
141 St Georges Terrace, Perth WA TEL: 1300 305 021
(Western Australia ONLY)
BIRTH CERTIFICATE APPLICATION FORM
Payment details over the page you MUST return pages 1 and 2 if applying via mail
Fees including standard postal delivery effective 1 July 2009 Subject to change without further notice No GST is payable on these certificates
BIRTH CERTIFICATE $44.00
(Payable in addition to the Birth Certificate fee. Does not include Express
PRIORITY FEE * $34.00 Post).
(Only applies where the full registration number is supplied by you and the
BIRTH CERTIFICATE (Reduced Fee) $31.00 birth is more than 75 years old. Otherwise full fee applies)
* Priority fee not payable for computerised certificates if applying in person at the Perth Registry Office or certain Regional Courthouses.
See Locations & Links webpage. For eligibility see the Birth certificate access policy on the Births webpage.
Identification and Certificate Access Requirements
See page 2 or visit [Link]
Processing Times for Mailed Certificate Applications
Standard - Please allow up to 2 working days plus postal delivery time
* Priority - Processed within 24 hours of receipt plus postal delivery time
BIRTH DETAILS REQUIRED Please PRINT clearly ABN: 70 598 519 443
Surname (at birth)
Given name(s)
Day Month Year
Date of birth / / Present age Male Female
Place of birth Suburb / Town
in Western Australia
Surname Given name(s)
Fathers name
Maiden surname Given name(s)
Mothers name
APPLICANTS DETAILS (please see next page for access conditions and identification requirements)
Full name
Postal address Suburb State Postcode
e.g. self, mother
Your Relationship to the person
Daytime phone number
whose certificate you are requesting
Email address
Passport Drivers licence Centrelink Bank requirements
Reason required Legal Marriage Lost
Family history
Other
Declaration: I declare that the information I have provided is true and correct. I understand that the WA Registry of Births, Deaths and Marriages
may make enquiries with any organisation or individual to verify the information provided with this application.
Signature must
SIGNATURE OF APPLICANT be completed
OFFICE USE ONLY
LIST 1 (with photo): Drivers Licence Passport Proof of Age Firearms Licence Defence/police Citizenship Cert Learners permit card
ID Ref: ...
LIST 2 : Birth Cert(Aust) Citizen papers Cr/Debit Card Health Medicare Centrelink Student card Travel Doc
ID Ref: ... ..
LIST 3 (current address): Bank Statement Rates notice Educational report Motor Vehicle Rego Utility account Rental agreement
ID Ref: ... If ID provided from Lists 2 and 3, one ID must contain a signature
Letter of Authority Other .. Initial ID sighted........
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Registry of Births Deaths and Marriages, Western Australia BDM1
BIRTH CERTIFICATE APPLICATION INSTRUCTIONS
HOW TO APPLY Tick the forms of identification that are supporting your application
POST the completed form (pages 1 & 2) to: LIST 1 - Evidence of link between photo & signature
Registry of Births, Deaths & Marriages Australian drivers licence (with photo)
PO Box 7720 Cloisters Square
PERTH WA 6850 OR Australian passport (with photo)
BRING the completed form (pages 1 & 2) to: Australian firearms licence (with photo)
Registry of Births, Deaths & Marriages
Level 10, 141 St Georges Terrace Perth Defence Force/Police ID card (with photo)
between 8.30 am - 4.30 pm, Monday to Friday
Australian Citizenship Certificate with evidence of
Note: Faxed applications will not be accepted residence status (with photo)
Over 18 or Proof of Age Identity card (with photo)
WHO CAN APPLY FOR A CERTIFICATE
Australian learner drivers permit card (with photo)
Birth certificates are available to the registered person
(16 years of age or over) or a parent named in the birth
certificate. LIST 2 - Evidence of operating in the community
If the certificate relates to a person other than yourself and you Debit or Credit card (one or the other, not both) issued
do not qualify under the Registrys Certificate Access Policy, you by a financial institution
must provide the written consent or authority from a person
entitled to the certificate and you must also provide Document of identity issued by the Passport Office
identification for yourself and the person for whom you are
acting. Entitlement card issued by the Commonwealth or State
Government (Centrelink, Health Care card, Veterans Affairs
Information regarding the Registrys Certificate Access policy is
card etc)
located on our website at [Link], or
telephone the Registry on 1300 305 021. Full Birth certificate issued in Australia (birth extracts
Privacy Considerations and Personal Records not accepted)
Certificates held by the Registry contain sensitive and personal Medicare card
information. However the Registry allows unrestricted access
for birth certificates which occurred more than 100 years ago. Naturalisation, citizenship or immigration papers
issued by Dept of Immigration & Border Protection (DIBP)
IDENTIFICATION REQUIREMENTS Overseas passport with current Australian Entry Permit
When applying for a Western Australian certificate, evidence of
your identity must be provided. Security guard or crowd control licence (Australian)
Student identity document or statement of
You MUST provide at least three forms of identification:
enrolment issued by an educational institution, including
One document from each List (1, 2 and 3). At least one Tertiary(should include photo and/or signature)
containing a photograph; or
Working with children card
One from List 1 and two from List 2. At least one
containing a photograph, or LIST 3 Evidence of current residential address
Two from List 2 and one from List 3. At least one
Drivers licence renewal notice
containing a signature.
All forms of identification MUST be current. Financial institution statement less than six months old
Documents from List 3 MUST show your current Motor vehicle registration
residential address.
Property lease or tenancy agreement
Bank statements, utility accounts or rates notices MUST
have been issued within the last six months. Shire/water rates notice
School or other educational report or certificate less
CERTIFICATION REQUIREMENTS than twelve months old
Applying in person - original documents must be provided. Utility account less than six months old (gas, electricity, home
Applying by post - please send clear certified photocopies of phone, etc)
your identification documents with your application.
FURTHER INFORMATION
Photocopies of identification will only be accepted if they are
For further information, please visit our website at
certified by a qualified witness as being true copies of the
[Link] or call 1300 305 021 between
original documents. See page 3 for Certifying documents.
8.30 am and 4.30 pm, Monday to Friday.
PAYMENT DETAILS If applying for more than one certificate only complete payment details on one form
Applicants Full Name
Enclosed is a cheque/money order* for $ OR Debit my MasterCard or Visa for $
* Your cheque or money order should be made payable to the Registry of Births, Deaths and Marriages
Card No Expiry Date /
Name of Cardholder Signature of
cardholder
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Registry of Births Deaths and Marriages, Western Australia
WHO CAN CERTIFY DOCUMENTS?
This page is NOT to be forwarded to the Registry of Births, Deaths and Marriages
Certifying documents (photocopies of identification)
Before certifying a document, ensure that the copy to be certified is an identical copy of the original.
Suggested wording for the certification is as follows:
I certify that this appears to be a true copy of the document produced to me on < date >
Signature
Name
Qualification (eg JP, Pharmacist)
List of persons who can Certify Documents:
Academic (post-secondary institution) Loss adjuster
Accountant Marriage Celebrant
Member of Parliament (State or
Architect
Commonwealth)
Australian Consular Officer Minister of religion
Australian Diplomatic Officer Nurse
Bailiff Optometrist
Bank Manager Patent Attorney
Chartered secretary Physiotherapist
Chemist Podiatrist
Chiropractor Police officer
Company auditor or liquidator Post Office manager
Court officer
(Judge, master, magistrate, registrar or Psychologist
clerk)
Defence Force officer (Commissioned,
Public Servant (State or
Warrant or NCO with 5 years continuous
Commonwealth)
service)
Dentist Public Notary
Doctor Real Estate agent
Engineer Settlement agent
Industrial organisation secretary Sheriff or deputy Sheriff
Insurance broker Surveyor
Justice of the Peace Teacher
Lawyer Tribunal Officer
Local government CEO or deputy CEO Veterinary surgeon
Local government councillor
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