This is an HTML version of an attachment to the Official Information request 'My wife's marital status as per NZ immigration'.

Complete on-screen and print  
You can complete this form on-screen using the Editable PDF functionality with Adobe Reader 
You must still print off the application and sign it by hand
BDM93M • Page 1/3  
Tono Tiwhikete Mārena o Aotearoa, Tānga rānei 
Request for New Zealand Marriage Certificate or Copy of Record
To order certificates online 
This form is to order a marriage certificate after a marriage has occurred and registered. If 
visit www.govt.nz/bdm
you want to give notice of an intended marriage go to http://marriages.services.govt.nz
If you want to use the certificate overseas refer to www.govt.nz/authentications
SECTION 1: Certificate details
Party 1 first and middle names (required)
Party 1 surname or family names (required)
Party 2 first and middle names (required)
Party 2 surname or family names (required)
Date of marriage (required)
Town or city of marriage (include country if not NZ)
Other information (e.g. folio number)
SECTION 2: Delivery address and contact details
Delivery name
Flat no
Street no
Street name
Suburb or rural locality
City, town or district
Postcode
Country (if not New Zealand)
Applicant's contact phone number
Applicant's email address
Last updated: 26 September 2019



Complete on-screen and print  
You can complete this form on-screen using the Editable PDF functionality with Adobe Reader 
You must still print off the application and sign it by hand
BDM93M • Page 2/3 
SECTION 3: Certificate style and quantity
 
Marriage 
Copy  
certificate
of Record
Enter quantity                                                                                                                                                                    Price 
The certificate will be sent folded with the 
Marriage certificate
$33
delivery address printed on the back. 
This is a copy of the marriage record usually used for genealogical 
Copy of the Record
$25
research and is not a legal document. It may be typed or handwritten.
If the record cannot be found we will contact you and search fees will apply
SECTION 4: Delivery method and payment
I want the certificate(s) sent by standard post
$0
I want the certificate(s) or copy of the record couriered to a New Zealand address
$5
I want the certificate(s) or copy of the record couriered to an overseas address
Australia, Asia, Pacific $15 
USA $20 
Europe $25 
Rest of the world $30
I am ordering a copy of the record and want it emailed
$0
I am ordering a copy of the record and want it sent by standard post
$0
Select how you will pay
Do not post cash
Visa
Mastercard
American Express
Prezzy card Do not post us 
your prezzy card
Card number
Expiry date
Name on card
Cardholder signature
I have enclosed a New Zealand cheque or International bank draft in NZ dollars made out to the 
Department of Internal Affairs.  Note: Australian money orders can only be receipted at the Sydney office.
Sections 5 and 6 on the next page are not required if the marriage certificate you are ordering is more than 80 years old.

Complete on-screen and print  
You can complete this form on-screen using the Editable PDF functionality with Adobe Reader 
You must still print off the application and sign it by hand
BDM93M • Page 3/3 
SECTION 5: Proof of identity
 
We check your details in this form against another identity record
Choose one of the following  to confirm your identity
OR include a photocopy of one of the 
following identity documents:
I was born in New Zealand
- Passport (NZ or overseas) 
I was married or entered into a civil union in New Zealand 
- Driver Licence (NZ or overseas) 
Date of marriage or civil union
- Kiwi Access Card (issued by Hospitality NZ)
- 18+ Card (issued by Hospitality NZ)
Town or city of marriage or civil union
- NZ Firearms or Dealer’s Licence 
- Salvation Army identity certification 
My child was born in New Zealand 
- NZ Refugee Travel Document
Child's date of birth
- NZ Emergency Travel Document
- NZ Certificate of Identity (Issued by 
Child's full name
Immigration NZ) 
- NZ Certificate of Identity (Issued under the 
Passport Act 1992) 
- Steps to Freedom document (issued by 
Department of Corrections)
Do not send the original
SECTION 6: Declaration
My first and middle names
My surname
My first and middle names at birth (if different)
My surname at birth (if different)
My date of birth
My town or city of birth, and country if not NZ
I am ordering on behalf of a company, and have included a signed request on company letterhead
I declare that the information above is true and correct. I understand that any person who makes a false statement 
will be liable on conviction to a fine or imprisonment, or both. I understand the information on this form is collected 
under the Births, Deaths, Marriages, and Relationships Registration Act 1995. As part of processing my request, I 
understand that my identification details will be checked against other records held by the Department of Internal 
Affairs or other government agencies, as authorised by law. I understand that my name will be recorded on the access 
register for any non-historical certificates that I order.
My signature
Date signed
Office Use Only      B      D
Submit your form 
By mail
In person
and payment
Certificate Team 
Visit www.govt.nz/bdmoffices for the 
Births, Deaths and Marriages 
location of offices in Auckland, 
Print 
PO Box 10526 
Manukau, Wellington, Christchurch, 
Form
Wellington 6143 
Sydney and London 
New Zealand