Use this form to give someone else authority to apply for your birth, marriage, replacement change of name or single status certificate, or a death certificate where you are the next-of-kin.

Author
Registry of Births, Deaths and Marriages Victoria
Publisher
Department of Justice and Regulation
Date of Publication

You may need Adobe® Acrobat® Reader or Libre Office to view the document(s) on this page.

Get Adobe® Acrobat® Reader (External link)

Get Libre Office (External link)