Form 1—Application for registration of a death abroad
(regulations 3 and 4)
Commonwealth of Australia
Registration of Deaths Abroad Regulations
Application for registration of a death abroad
PARTICULARS OF DECEASED
1
Surname
2
Christian or given names
3
Date and time of death (as precisely as is known)
4
Place of death
5
If death occurred on board a flying craft or ship:(a) name or flight number of flying craft or name of ship(b) name of carrier or registered owner(c) location of craft or ship at time of death(d) port of origin of the flight or voyage(e) port of destination of the flight or voyage
6
Sex
7
Age at death
8
Place of birth
8A
Last known occupation
9
Nationality
10
Conjugal status
11
Name of spouse
12
Names and ages of living children
13
Father’s full name
14
Mother’s full name and maiden surname
15
Usual place of residence
16
Where the person resided in a State or Territory of Australia at any time:(a) the address or addresses at which the person resided in any such State or Territory, so far as known to the applicant(b) the period or periods during which the person resided at that address, or each of those addresses, so far as known to the applicant
17
Grounds (if any) on which the applicant has reason to believe that the person:(a) was an Australian citizen(b) ordinarily resided in Australia or in an external Territory of Australia(c) was in receipt of a pension, allowance or benefit under the Social Security Act 1991(d) was in receipt of a pension, allowance or benefit under the Veterans’ Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004
PARTICULARS OF BENEFITS PAYABLE BY COMMONWEALTH
18
If the deceased was in receipt of a salary, pension, allowance or other benefit from the Commonwealth or an authority of the Commonwealth, details of the benefit
MEDICAL PARTICULARS
19
Cause of death (if known)
20
Name of medical practitioner, coroner or other authority furnishing medical particulars
PARTICULARS OF BURIAL/CREMATION (omit whichever is not applicable)
21
Date of burial/cremation
22
Place of burial/cremation
PARTICULARS OF APPLICANT
23
Surname
24
Christian or given names
25
Usual place of residence and other address (if any) for correspondence
26
Relationship to deceased
27
If not related, duration of period applicant knew deceased
28
Grounds on which the applicant knows the identity of the deceased
29
Title or rank
30
Occupation
31
Whether an application for registration of the death has been made to any other authority
32
Authority to which that application was made
33
Whether that application was refused
34
Signature of applicant certifying correctness of particulars
35
Date of signing
Form 2—Application for registration of the death abroad of a person who has disappeared
(regulations 3 and 4)
Commonwealth of Australia
Registration of Deaths Abroad Regulations
Application for registration of the death abroad of a person who has disappeared
PARTICULARS OF PERSON WHO HAS DISAPPEARED
1
Surname
2
Christian or given names
3
Date and time when person was last seen alive
4
Place where person was last seen alive
5
Names and addresses of persons who last saw that person alive
6
Such particulars of the time at which, the date on which, and the circumstances in which, the person disappeared as are known to the applicant
7
Particulars of the grounds the applicant has for believing that the person has died
8
Particulars of the flying craft or ship from which the person disappeared(a) name or flight number of flying craft or name of ship(b) name of carrier or registered owner(c) location of flying craft or ship at time of disappearance(d) port of origin of the flight or voyage(e) port of destination of the flight or voyage
9
Sex
10
Age at time of disappearance
11
Place of birth
11A
Last known occupation
12
Nationality
13
Conjugal status
14
Name of spouse
15
Names and ages of living children
16
Father’s full name
17
Mother’s full name and maiden surname
18
Usual place of residence
19
Where the person resided in a State or Territory of Australia at any time:(a) the address or addresses at which the person resided in any such State or Territory, so far as known to the applicant(b) the period or periods during which the person resided at that address, or each of those addresses, so far as known to the applicant
20
Grounds (if any) on which the applicant has reason to believe that the person(a) was an Australian citizen(b) ordinarily resided in Australia or in an external Territory of Australia(c) was in receipt of a pension, allowance or benefit under the Social Security Act 1991(d) was in receipt of a pension, allowance or benefit under the Veterans’ Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004
PARTICULARS OF BENEFITS PAYABLE BY COMMONWEALTH
21
If the person was in receipt of a salary, pension, allowance or other benefit from the Commonwealth or an authority of the Commonwealth, the nature of the benefit
DOCUMENTS IN SUPPORT OF APPLICATION
22
List the documents furnished as evidence that the person is dead
PARTICULARS OF APPLICANT
23
Surname
24
Christian or given names
25
Usual place of residence and other address (if any) for correspondence
26
Relationship to deceased
27
If not related, duration of period applicant knew deceased
28
Grounds on which the applicant knows the identity of the person who has disappeared
29
Title or rank
30
Occupation
31
Whether an application for registration of the death has been made to any other authority
32
Authority to which that application was made
33
Whether that application was refused
34
Signature of applicant certifying correctness of particulars
35
Date of signing
Form 3—Certificate of an entry in the register of deaths abroad
(paragraph 8 (a))
Commonwealth of Australia
Registration of Deaths Abroad Regulations
Certificate of an entry in the register of deaths abroad
I, (insert full name), the Registrar of Deaths Abroad, certify that the above is a true copy of an entry in the Register of Deaths Abroad kept by me under the Registration of Deaths Abroad Act 1984.
Dated (insert date).
Registrar
Form 4—Certificate of an extract from an entry in the register of deaths abroad
(paragraph 8 (b))
Commonwealth of Australia
Registration of Deaths Abroad Regulations
Certificate of an extract from an entry in the register of deaths abroad
I, (insert full name), the Registrar of Deaths Abroad, certify that an entry in the Register of Deaths Abroad kept by me under the Registration of Deaths Abroad Act 1984 gives the following particulars concerning the death of (insert name of person who has died or of person who has disappeared and is deemed to have died):
Date of death or Date on which person was last seen alive*
Place of death or Location of flying craft or ship when person was last seen alive*
Dated (insert date).
Registrar
* Omit whichever is not applicable
Schedule 2—Certificate of a death abroad
(regulation 5)
PARTICULARS OF PERSON WHO HAS DIED OR DISAPPEARED
1
Surname
2
Christian or given names
3
Date of death or date on which person was last seen alive
4
Place of death or location of flying craft or ship when person was last seen alive
5
Sex
6
Age at death or disappearance
7
Place of birth
7A.
Last known occupation
8
Usual place of residence
9
Nationality
10
Conjugal status
11
Name of spouse
12
Names and ages of living children
13
Father’s full name
14
Mother’s full name and maiden surname
MEDICAL PARTICULARS
*15
Cause of death
*16
Name of medical practitioner, coroner or authority furnishing particulars
PARTICULARS OF BURIAL/CREMATION (omit whichever is not applicable)
*17
Date of burial/cremation
*18
Place of burial/cremation
PERSON FURNISHING PARTICULARS
19
Surname
20
Christian or given names
21
Usual place of residence and address (if any) for correspondence
22
Relationship to deceased
23
Title or rank
24
Occupation
25
Name of the Registrar
26
Place of registration
27
Date application received by the Registrar
* These particulars do not apply in the case of a person who has disappeared