Commemorative birth certificate application form

Required fields are marked with an *

Consent
* By using this online service and by providing an email address and mobile number, I consent to the Registry of Births, Deaths and Marriages (RBDM) contacting me electronically about this application. I understand that it is my responsibility to ensure that I have nominated a secure email address and mobile number and to ensure security of information when received.
* Choose from the following designs
1. Tell us about you
  1. Your name
    First name *
    
    Middle name(s)
    
    Family name (as shown on birth certificate) *
  2. Your place of birth
    Town or city *
    
    State or territory *
    
    Country *
  3. Your date of birth * dd/mm/yyyy
  4. What was your mother or registered parent's family name at birth? * This is your mother or parent's family name at the time of their birth.
  5. Your mother or parent's family name at birth may not have changed and may be their current family name.
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Please take the time to look over the details you have provided before paying.

Privacy notice

The Department of Justice is collecting your personal information to process your application for birth certificates under the Births, Deaths and Marriages Registration Act 2023. The information on this form may be provided to law enforcement agencies and to government and non-government agencies to verify the data. Access to this information or a certificate may be granted to any person who has adequate reason to obtain it, or who meets the requirements of the access policy.

Managed by: Registry of Births, Deaths and Marriages

Last updated:: 10 February 2026

Commemorative birth certificate application form

Consent

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Privacy notice