BIRTH CERTIFICATE APPLICATION FORM

The Register Office
Redcar & Cleveland Leisure and Community Heart
Ridley Street
Redcar
TS10 1TD
FOR OFFICE USE ONLY
DATE RECEIVED
REFERENCE
Telephone: 01642 444440
email: [email protected]
DATE OF ISSUE
BIRTH CERTIFICATE APPLICATION FORM
(Please complete form in full)
Your Name:
Mr
Mrs
…………………………………………………………………………………………………………….
Miss/Ms
(State name in full)
Your Address: ………………………………………………………………………………………………………………….
…………………………………………………………………… Telephone No: ………………………..
Postcode:…………………………..
Signature………………………………..
Details of Birth Certificate Required:
1)
Full name at Birth……………………………………………………………………………………………….
2)
Date of Birth……………………………………………………………………………………………
3)
Place of Birth……………………………………………………………………………….……………….
4)
Parent 1 Full Name………………………………………………………………………………………….
5)
Parent 2 Full Name…………………………………………………………………………………………
6)
Maiden Name of parent……………………………………………………………………………………
NAME AS RECORDED ON THE CARD:
Total Amount to be charged:
CARD NUMBER:
EXPIRY DATE:
3 DIGIT SECURITY NUMBER:
ISSUE NUMBER:
Cost of Certificate: - £24.00 Standard Certificate (Priority Service)
£13.00 Standard Certificate prepared within 3 working days, posted first class
£12.00 Standard Certificate prepared within 3 working days, to be collected from The
Register Office
OVERSEAS POSTAGE WILL BE CHARGED SEPARATELY
(If applying for this certificate by post please make cheques and postal orders payable to: Superintendent
Registrar
ver 02/08/16
The Register Office
Redcar & Cleveland Leisure and Community Heart
Ridley Street
Redcar
TS10 1TD
FOR OFFICE USE ONLY
DATE RECEIVED
REFERENCE
Telephone: 01642 444440
DATE OF ISSUE
email: [email protected]
DEATH CERTIFICATE APPLICATION FORM
(Please complete form in full)
Your Name:
Mr
Mrs
…………………………………………………………………………………………………………….
Miss/Ms
(State name in full)
Your Address: ………………………………………………………………………………………………………………….
…………………………………………………………………… Telephone No: ………………………..
Postcode:…………………………..
Signature………………………………..
Details of Death Certificate required:
1)
Full name of deceased…………………………………………………………………………………
2)
Date of Death……………………………………………………………………………………………
3)
Place of Death……………………………………………………………………………….…………
4)
Age/Date of Birth of
Deceased……………………………………………………………………………………………….
5)
Spouse of Deceased………………………………………………………………………………
NAME AS RECORDED ON THE CARD:
Total Amount to be charged:
CARD NUMBER:
EXPIRY DATE:
3 DIGIT SECURITY NUMBER:
ISSUE NUMBER:
Cost of Certificate: - £24.00 Standard Certificate (Priority Service)
£13.00 Standard Certificate prepared within 3 working days, posted first class
£12.00 Standard Certificate prepared within 3 working days, to be collected from
The Register Office
OVERSEAS POSTAGE WILL BE CHARGED SEPARATELY
(If applying for this certificate by post please make cheques and postal orders payable to: Superintendent
Registrar
The Register Office
Redcar & Cleveland Leisure and Community Heart
Ridley Street
Redcar
TS10 1TD
FOR OFFICE USE ONLY
DATE RECEIVED
REFERENCE
Telephone: 01642 444440
email: [email protected]
DATE OF ISSUE
MARRIAGE CERTIFICATE APPLICATION FORM
(Please complete form in full)
Your Name:
Mr
Mrs
…………………………………………………………………………………………………………….
Miss/Ms
(State name in full)
Your Address: ………………………………………………………………………………………………………………….
…………………………………………………………………… Telephone No: ………………………..
Postcode:…………………………..
Signature………………………………..
Details of Marriage Certificate required:
1)
Full name party 1……………………………………………………………………………………………….
2)
Full name party 2 ……………………………………………………………………………………………
3)
Date of Marriage……………………………………………………………………………….……………….
4)
Place of Marriage……………………………………………………………………………………………….
NAME AS RECORDED ON THE CARD:
Total Amount to be charged:
CARD NUMBER:
EXPIRY DATE:
3 DIGIT SECURITY NUMBER:
ISSUE NUMBER:
Cost of Certificate: - £24.00 Standard Certificate (Priority Service)
£13.00 Standard Certificate prepared within 3 working days, posted first class
£12.00 Standard Certificate prepared within 3 working days, to be collected from
The Register Office
OVERSEAS POSTAGE WILL BE CHARGED SEPARATELY
(If applying for this certificate by post please make cheques and postal orders payable to: Superintendent
Registrar