Births, Deaths, and Marriages Information

Births Deaths and Marriages information required to apply for a NSW Death Certificate.

Please provide accurate details to ensure proper registration. You can save your progress and continue later if needed.

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Step 1 of 6

Phone

This field is for validation purposes and should be left unchanged.

Deceased’s Details

Family Name

Family Name at Birth

First Given Name

Other Given Name(s)

Date of Birth

Date of Death

Date of Death Type

Sex

Age

Please select

Place of Death

Did the death occur in a NSW Hospital or Nursing Home?

Location

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Residential Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Place of Birth

Country of Birth

Suburb/ Town / City of Birth

State / Territory

Date of arrival in Australia

Period of Residency in Australia

Occupation

Main Occupation Activity

Retired at Date of Death

Pensioner at Date of Death

Aboriginal or Torres Straight Islander

Pension type

Deceased’s Marriage Details

Usual Doctor's Name

Usual Doctor's Phone Number

Usual Doctor's Address / Medical Centre

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Does the deceased have a pacemaker or defibrillator fitted?

Height*

(we require for transfers and casket sizing)

Weight*

(we require for transfers and casket sizing)

Is there a prepaid funeral bond in place?

Name of the Bond Provider

Phone Number

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Marital Status at Time of Death

Location of Marriage

Country

Suburb/Town/City

Age at Commencement

Previous Marriage or Defacto Relationships

Location of Marriage

Country

Suburb/Town/City

Age at Commencement

Previous Marriage or Defacto Relationships

Location of Marriage

Country

Suburb/Town/City

Age at Commencement

Previous Marriage or Defacto Relationships

Location of Marriage

Country

Suburb/Town/City

Age at Commencement

Number of Children of the Deceased

Family Name

First Given Name

Other Given Names(s)

Life Status

Date of Birth

Age - years, seconds, minutes, hours, weeks, months

Sex

Child 2

Family Name

First Given Name

Other Given Names(s)

Life Status

Date of Birth

Age - years, seconds, minutes, hours, weeks, months

Sex

Child 3

Family Name

First Given Name

Other Given Names(s)

Life Status

Date of Birth

Age - years, seconds, minutes, hours, weeks, months

Sex

Child 4

Family Name

First Given Name

Other Given Names(s)

Life Status

Date of Birth

Age - years, seconds, minutes, hours, weeks, months

Sex

Child 5

Family Name

First Given Name

Other Given Names(s)

Life Status

Date of Birth

Age - years, seconds, minutes, hours, weeks, months

Sex

Informant’s Details

Family Name

First Given Name

Other Given Name(s)

Relationship to Subject

Country of Residence

Contact Phone Number

Residential Address

Street Address City State / Province / Region ZIP / Postal Code Country

Email Address

Births, Deaths, and Marriages Information

Deceased’s Details

Place of Birth

Deceased’s Marriage Details

Spouse Details

2nd Spouse

3rd Spouse

4th Spouse

Number of Children of the Deceased

Child 2

Child 3

Child 4

Child 5

Parents of the Deceased

Informant’s Details