Birth Certificate Application Form

Published on December 2016 | Categories: Documents | Downloads: 61 | Comments: 0 | Views: 546
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Use this form to request a copy of a birth certificate from us.

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PLEASE NOTE
THIS APPLICATION FORM
MUST BE COMPLETED IN FULL
BIRTH CERTIFICATE
POSTAL APPLICATION FORM

TODAYS DATE: …………………………

YOUR FULL NAME: ……………………………………………………………………..

POSTAL ADDRESS: ……………………………………………………………………..

POST CODE: ………………………………TEL NO: ....………………………………..
Are you applying for your own birth certificate? (PLEASE TICK BOX) YES NO
If not please state your relationship to the person
to whom the certificate relates

…………………………………………….....
Please state for what the purpose the certificate is
required?

…………………………………………….....
If the person has ever been legally adopted DO NOT complete this form but ask Barnsley Registration
Service for the relevant application form
DETAILS OF BIRTH CERTIFICATE REQUIRED
Cheque/Postal Order for £10.00 enclosed
(made payable to Barnsley MBC)
Yes No

NAMES GIVEN AT BIRTH
FIRST NAME(S)



SURNAME
DATE OF BIRTH



PLACE OF BIRTH




MOTHER’S NAME


FATHER’S NAME



MOTHER’S MAIDEN SURNAME



FOR OFFICIAL USE ONLY

REGISTER NO.:



ENTRY/PAGE NO.:


CERTIFICATE NO.:



DATE COMPLETED:



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