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Death Registration Online Form

This form is required by law to be filled out by the next of kin or family member. It will require you to have various legal information, so it is always best to have certain documents with you.

The information you provide on this form will be sent to Birth, Death and Marriages NSW and an official Death certificate will be issued using the information you have provided.

You can also download and print the form by clicking on the download button below.

DOWNLOAD FORMCONTACT US

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    Step 1

    Details

    Name *

    Email *

    Phone *

    Address

    0%

    Deceased Information

    Name *

    Gender *

    Last Known Residential Address

    Date of Death

    Date of Birth *

    Age *

    Place of Death *

    Place of Birth *

    Migration Date or Year

    Occupation During Working Life *

    Pensioner *

    Retired *

    Pension Type

    Aboriginal or Torres Strait Island origin

    20%

    Deceased Marriage Details

    Please state all marriages including divorced or deceased spouses.

    Marital Status *

    Spouse Full Name

    Please enter spouse details even if they are divorced or widowed.

    Place of Marriage

    Please enter spouse details even if they are divorced or widowed.

    Age at time of Marriage

    More than one marriage

    Maiden Name

    Please enter spouse details even if they are divorced or widowed.

    40%

    Deceased's Children Details

    Please state all children alive or deceased including stillborn children by order of birth.

    Did the Deceased have children? *

    How Many children?

    Child 1 Full Name

    Child 1 Life Status

    Child 1 Date of Birth

    Child 1 Gender

    Child 2

    Child 2 Full Name

    Child 2 Life Status

    Child 2 Date of Birth

    Child 2 Gender

    Child 3

    Child 3 Full Name

    Child 3 Life Status

    Child 3 Date of Birth

    Child 3 Gender

    Child 4

    Child 4 Full Name

    Child 4 Life Status

    Child 4 Date of Birth

    Child 4 Gender

    Child 5

    Child 5 Full Name

    Child 5 Life Status

    Child 5 Date of Birth

    Child 5 Gender

    Did the deceased have more than 5 children?

    60%

    Deceased Parents Details

    Deceased's Parents details. If any fields are unknown please write "unknown" in them.We still need these details even if they are deceased or retired. please enter unknown for any unknown items.

    Mothers Full Name *

    Mothers Surname from Birth *

    Mothers Occupation *

    EG: Home Duties, Teacher etc. Please enter A trade or type of employment even if they are deceased or retired. - please also define the main activity of this occupation

    Fathers Full Name *

    Fathers Surname from Birth *

    Fathers Occupation *

    EG: Home Duties, Teacher etc. Please enter A trade or type of employment even if they are deceased or retired. please also define the main activity of this occupation

    Informant Details

    This is the person who provided the information above and will also be receiving the death certificate.

    Name *

    Address *

    Phone *

    Email *

    Did the deceased have a pace maker?

    Name and Address of last seen General Practitioner

    We need full name and address of the doctor the deceased used regularly towards the end of life. If unknown, please write "Unknown"

    80%

    Service Information

    If you are having a direct service Please go ahead and submit the form. If you are having a service, you can enter some of the information below.

    Are you having a Service or Direct Cremation or Burial?

    Preferred Date / Time for the service

    Are you having the service at our Chapel in Roselands or Elsewhere?

    if Else Where, please specify where you would like to hold the service?

    Do you wish to Book in a Celebrant or Clergy

    If you would like to book in a celebrant or Clergy for your service, please choose one of the options above.

    Photo Upload

    Please feel free to upload photos here. You can upload up to 10 photos. Which can be used on your memorial photo frames or Memorial cards.

    Have you made Music Selections?

    If you would like to book in a celebrant or Clergy for your service, please choose one of the options above.

    Coffin Selection

    If you have seen the Full Package inclusion Pdf in your quote, it will demonstrate the available coffin selections in your package.

    Floral Selection

    Please enter the colour of flowers you would like for the floral casket cover.

    100%