Death Certificate Application Form

Record Services NZ » Death Certificate » Application Form

Death Certificate - Application Form

"*" indicates required fields

Step 1 of 4

Certificate details

Deceased’s first and middle names*

Deceased’s surname or family names*

Date of the death*

If the date of death was 10 days ago or less, the death may not yet be registered. This may delay your certificate order

Your details

As the person ordering the certificate, you need to provide some basic information about yourself so we know who is requesting the record. Your name will then be recorded in the access register. Learn more about the access register.

Your first and middle names*

Your surname or family names*

Your IRD Number*

Your date of birth*

Select one of the statements below:*

I was born in New Zealand (EASIEST METHOD)

I got married or had a civil union in New Zealand

My child was born in New Zealand

None of the above apply to me

Unfortunately you can’t order using this online service. Ask a relative or friend to request the certificate on your behalf.

Was your name different at birth?*

Yes

Your first and middle names (at the time of birth)*

Your surname or family names (at the time of birth)*

Your place of birth*

Your partner’s first and middle names (before the marriage or civil union)*

Your partner’s surname or family name (before the marriage or civil union)*

Place of the marriage or civil union

Date of the marriage or civil union*

Your child’s first and middle names*

Your child’s surname or family name*

Your child's place of birth

Your child's date of birth*

Delivery and contact details

Enter your delivery and contact details below. If we have any issues with your order we will contact you via phone, email or post.

Name for delivery*

Your contact phone number

Email*

Enter Email Confirm Email

Address*

Enter unit/house number and street Enter suburb or any other appropriate description City or town State / Province / Region Postcode Country

Certificate type:	Death Certificate
Delivery time:	1–2 weeks
Total	$95.00