Registration of Identity of Persons Regulations 1975 (WA)
Western Australia
REGISTRATION OF IDENTITY OF PERSONS ACT 1975
These regulations were repealed by the
Western Australia
Western Australia
REGISTRATION OF IDENTITY OF PERSONS ACT 1975REGISTRATION OF IDENTITY OF PERSONS ACT 1975
These regulations may be cited as the
In these regulations unless the contrary intention appears —
An application to the Registrar General for the entry of a person’s identity in the Register pursuant to subsection (3) of section 4 shall —
(a) in the case of a person who has attained the age of eighteen years, be in the form of Form 1; and
(b) in the case of a person who has not attained the age of eighteen years, be in the form of Form 2.
An application to the Registrar General for the entry of a change of name in the Register pursuant to subsection (1) of section 11 shall be in the form of Form 3.
The names of the persons whose identities are entered in the Register shall be indexed in any index of names made for the purposes of the
The fees prescribed in the First Schedule are payable in respect of the several matters set forth in that Schedule.
$ | |
Application for registration of identity ....................................... | 4.00 |
Amendment of Register............................................................. | 0.50 |
Search in the index — for each five years or part thereof............. | 0.50 |
Certified copy of a registration of identity................................... | 2.00 |
Application for entry of change of name in the Register............... | 1.00 |
APPLICATION FOR REGISTRATION OF IDENTITY (For a person over the age of 18 years)
Present Name ...............................................................................................
Surname (Block Letters) Other Names
Name Given at Birth .....................................................................................
Surname Other Names
Address: Post Code
Residential ..................................................................
Postal ..........................................................................
Conjugal Status:
Single Married Widowed Divorced
(Tick whichever applies)
Details of Marriage:
Date........................... 19.................. Place..................................................
Town Country
Details of Birth:
Date........................... 19.................. Place..................................................
State precise place if known
e.g. Name of Hospital.
Name of Father ......................................
Surname Other Names
Name of Mother .....................................
Surname at time of
above birth
..............................
Maiden Surname
Change of Name: If name has been changed since birth other than by marriage, state former name, also attach documentary evidence e.g. License, Deed Poll, etc. | ............................. Former Name |
DECLARATION
I,
of
................................................................... in the State of Western Australia,
(a).... I was born in the State of Western Australia.
(b).... No trace can be found of the registration of my birth and I attach a certificate to this effect from the Registrar General of every State and Territory of the Commonwealth.
(c).... Registration of my birth was refused by the Registrar General on application made for that purpose because ..................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
(d).... The statements made in this application are true in every particular and the evidence of identity refers to me.
......... And I make this solemn declaration by virtue of section one hundred and six of the
Declared at ....................................... this......................................... day of ............................................. 19..... , before me ........................................................ Justice of the Peace. | |
Note: — If a Justice of the Peace is not available, this declaration may be made before any of the following persons: —
Town Clerk, Shire Clerk, Electoral Registrar, Postmaster, Classified Officer in the State or Commonwealth Public Service, Classified State School Teacher or Member of the Police Force.
CERTIFICATE REGARDING APPLICANT
I, .............................................................. ..............................................
Title or Profession
of .................................................................................................................
hereby declare that I have known personally the applicant ................................
.......................................................... for a period of .......................... years.
Applicant’s Name
No fee has been charged for this Certificate.
Date.............................. 19 ........ Signature ..............................................
APPLICATION FOR REGISTRATION OF IDENTITY (For a person under the age of 18 years)
Present Name ...............................................................................................
Surname (Block Letters) Other Names
Name Given at Birth......................................................................................
Surname Other Names
Address: Post code
Residential ..................................................................
Details of Birth:
Date.............................. 19........ Place ....................................................
State precise place if
known e.g. Name of Hospital
Name of Father ......................................
Surname Other Names
Name of Mother .....................................
Surnameattimeof Other Names
above birth
................................
Maiden Surname
Are Mother and/or Father Still Living .............................................................
If so state their present address .......................................................................
Change of Name:
If name has been changed since birth state former name, also attach documentary evidence e.g. License to Change Name. | .............................. Former Name |
R.G. 522
DECLARATION
I,
of
in the State of Western Australia,
do solemnly and sincerely declare that: —
(a).... I am the ...................................... of .........................................
............................................................... (father, mother, guardian etc.)
(b).... The said ................................................ was born in the State of Western Australia.
(c).... No trace can be found of the registration of his/her birth and I attach a Certificate to this effect from the Registrar General of every State and Territory of the Commonwealth.
(d).... Registration of the birth was refused by the Registrar General on application for that purpose made by me because.......................................................................................
............................................................................................................
............................................................................................................
(e).... The statements made in this application are true in every particular and the evidence of identity refers to the said ............................................................................................
............................................................................................................
And I make this solemn declaration by virtue of section one hundred and six of the
Declared at ....................................... this......................................... day of ............................................. 19..... , before me ........................................................ Justice of the Peace. | |
Note: — If a Justice of the Peace is not available, this declaration may be made before any of the following persons: — Town Clerk, Shire Clerk, Electoral Registrar, Postmaster, Classified Officer in the State or Commonwealth Public Service, Classified State School Teacher or Member of the Police Force.
CERTIFICATE REGARDING CHILD
I, ...................................................................
Title or Profession
of .................................................................................................................
hereby declare that I have known personally ...................................................
Child’s Name
for a period of .................................... years. No fee has been charged for this Certificate.
Date.............................. 19 ........ Signature ..............................................
Western Australia
APPLICATION RELATING TO CHANGE OR ASSUMPTION OF NAME
(Address) .........................................................
(Date) ..............................................
The Registrar General, 22 St. George’s Terrace, Perth, W.A.
Sir,
Whereas ........................................................................................................
(Name in full prior to assumption of new name)
has lawfully assumed the name of ...................................................................
.....................................................................................................................
I now request that an entry referring to such change or assumption of name be made in the margin of the Registration of the identity of the said ................. ................................................... who was born on .......................................
at ..................................................................................................................
The fee of $1.00 is enclosed (see Note 2 in instructions above) together with the Deed Poll, Licence, Statutory Declaration. (cross out whichever is inapplicable).
Yours faithfully,
………………………………………………
(Signature of Applicant)
15 Apr 1976 pp.1179‑82 | 15 Apr 1976 | |
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