Information Required for Death Certificates

This is the information required for a death certificate. Feel free to print off this form and keep the completed version with your records.

    Personal Details

    First Name

    Last Name

    Name at birth (if different)

    Date of Birth

    Place of Birth - Town or City and Country

    If born overseas how long lived in NZ

    Usual residence


    Usual occupation

    Family Details

    Age and gender of each living child (if child deceased, age at death)

    Full name and maiden name of Mother

    Occupation of Mother

    Full name of Father

    Occupation of Father

    Relationship Details

    Marriage or relationship details at time of death. Most recent and any previous.

    If married, place of marriage

    Age of deceased at marriage

    Full name and age of spouse/partner

    Was the deceased a Marriage/Civil Union Celebrant or Justice of The Peace

    Did the deceased hold any national honour or award