Transcription of Death Certificate Application form - BDM2
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Death Certificate Application form - BDM2
As at 01/07/2019 Page 1 of 3 Death Certificate Application FORM (Western Australia ONLY) Payment details over the page you MUST return pages 1 and 2 if applying via mail Identification and Certificate Access Requirements See page 2 or visit Processing Times for Mailed Certificate Applications Tax Receipt required Standard Please allow up to 2 working days plus regular postal delivery time * Priority Processed within 24 hours of receipt plus priority postal delivery time Death DETAILS REQUIRED Please PRINT clearly ABN: 70 598 519 443 Surname Given name(s) Date of Death Day Month Year Age at Death Male Female / / Place of Death in Western Australia Suburb / Town Parent s full name Given name(s) Surname Maiden Surname (if applicable) Parent s full name Given name(s) Surname Maiden Surname (if applicable) APPLICANT S DETAILS (please see next page for access co)
As at 20/6/2018 Page 3 of 3 BDM50 WHO CAN CERTIFY DOCUMENTS? Certifying documents (photocopies of identification) Before certifying a document, ensure that the copy to be certified is an identical copy of the original.
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