If you're sending your payment from anywhere other than Canada, you must pay with an international money order in Canadian funds drawn on a Canadian clearing house, or by VISA, MasterCard or American Express. We will not accept post-dated cheques. We will charge $35.00 if your cheque is rejected because of insufficient funds.
There is a limit on the number of documents issued. (See #7 on pg. 4). Please note that fees are subject to change without notice. If you send your request by mail, you can pay by cheque or money order, made payable to Minister of Finance, or by VISA, MasterCard or American Express. At our public counter, you can also pay by cash or debit card.
Credit card payment: You must pay by credit card if you are faxing your application to us. Our fax number is 807 343-7459.
Signature of Cardholder
Date of Birth Year Month Day
Place of Birth (City) Weight at Birth No. of older brothers/sisters born before this child
Where did the birth take place Hospital Hospital (name) Home Birthing Centre Other Other (specify)
You must check one box Physician Midwife Other Undetermined
Name of Doctor or Attendant (at birth) Address of Doctor or Attendant
Mother's Maiden Name (see #1 on pg. 4) First Name Middle Name(s) Mother's Address (at the time of this child's birth) City Province Country Mother's Marital Status (at time of this child's birth) Single Married Divorced Widowed Common law
Any Other Last Name(s) Used by Mother Mother's Age (at time of this birth)
Mother's Date of Birth Year Month Day
Mother's Place of Birth (City and Province/Country) Father / Other Parent Last Name First Name Middle Name(s) Father / Other Parent Age (at time of this birth) Father / Other Parent Date of Birth Year Month Day
Has a Birth Certificate (Short Form) been previously issued for this birth? All previously issued documents will be cancelled.
Has a Certified Copy of the Birth Registration been previously issued for this birth? All previously issued documents will be cancelled.
Has the person named on the Birth Registration ever had a legal name change? Yes No
If 'yes', provide previous name(s) below:
**All previously issued documents will be cancelled.
Where the person named on the certificate is alive (Check one or more boxes)
A parent of the person named on the Birth Certificate is the 'Applicant'. (Your name must appear on the Birth Registration)
Where the person named on the certificate is deceased, only a Certified Copy of the Birth Registration will be issued. (Check one or more boxes)
You MUST check one of the following boxes:
I authorize the Office of the Registrar General to issue the requested document/information, and consent to the Ministry of Government Services collecting information about myself and the person named on the Birth Certificate (if other than myself) from the guarantor and such other sources as may be necessary to verify the information on this form and my entitlement to the service required and to the disclosure of such information to the Ministry of Government Services. I am aware that it is an offence to wilfully make a false statement on this form.
Signature of Applicant
Date Signed
To the Applicant Please select one of the following persons to act as your Guarantor. When contacted, the Guarantor will be asked to verify that:
No person shall charge a fee for acting as a guarantor (Section 45.1(2) of the Vital Statistics Act). The Applicant certifies that the individual named below has consented to act as Guarantor.
The Guarantor The persons described in this section are prescribed as guarantors for the purposes of section 45.1 of the Vital Statistics Act
1. Canadian citizens who have known the applicant for at least two years and who are currently serving as one of the following:
i. Judge, justice of the peace, municipal police officer, provincial police officer or officer of the Royal Canadian Mounted Police, First Nations police officers and constables. ii. Mayor. iii. Member of the Legislative Assembly of Ontario. iv. Minister of religion authorized under provincial law to perform marriages. v. Municipal clerk or treasurer who is a member of the Association of Municipal Managers, Clerks and Treasurers of Ontario. vi. Notary public. vii Principal or vice-principal of a primary or secondary school. viii. Senior administrator or professor in a university or a senior administrator in a community college or in a CEGEP in Quebec. ix. Signing officer of a bank, caisse d'économie, caisse populaire, credit union or trust company. x. Chief of a band recognized under the Indian Act (Canada).
Canadian citizens who have known the applicant for at least two years and who are practicing members in good standing of a provincial regulatory body established by law to govern one of the following professions: i. Chiropractor, dentist, midwife, nurse, optometrist, pharmacist, physician or surgeon, psychologist or veterinarian. ii. Lawyer. iii. Professional accountant. iv. Professional engineer. v. Social worker or social service worker. vi. Teacher in a primary or secondary school The list above is not an endorsement by the Office of the Registrar General of professional status or recognition of superior qualifications.
Work address
Personal information contained on this form is collected under the authority of the Vital Statistics Act, R.S.O. 1990, c.V.4 and will be used to provide certified copies, extracts, certificates, or search notices and to verify the information provided and your entitlement to the service requested and for law enforcement and security purposes. It is an offence to wilfully make a false statement on this form. Questions about this collection should be directed to: The Deputy Registrar General, Office of the Registrar General, 189 Red River Road, PO Box 4600, Thunder Bay ON P7B 6L8. Telephone Outside Toronto 1 800 461 2156 or in Toronto 416 325-8305 or Fax. 807 343-7459.
Instruction #1 Mother's Maiden Name Mother's maiden name is the mother's last name at the time of her own birth, unless the mother was adopted. If the mother was adopted, record the adoptive name.
Instruction #2 Next of Kin includes: *Spouse, **Common Law Partner, Mother, Father / Other Parent, Daughter, Son, Sister, Brother. If none of the above are available, the closest surviving Next of Kin (Grandmother, Grandfather, Aunt, Uncle, First Cousin, Niece, Nephew or Grandchild) may apply but must provide, along with the prescribed fees and a complete and signed application, an affidavit swearing that they are the closest surviving Next of Kin.
*Spouse means either party to a marriage. **Common Law Partner means two people living together continuously in a conjugal relationship outside of marriage for a period of no less than 3 years or two people who have lived together in a relationship of some permanence if they are the parents of a child.
Instruction #3 Proof of Death i.e., Death Certificate, Funeral Director's Statement, Certificate of Appointment of Estate Trustee or, an order under the Declarations of Death Act, 2002.
Instruction #4 Estate Trustee includes an Executor or an Administrator.
Instruction #5 Acceptable proof includes a Certificate of Appointment of Estate Trustee, letters probate, letters of administration or a will.
Instruction #6 Lost, Stolen, Damaged/Destroyed Birth Certificates Birth Certificates or certified copies of Birth Registration that are lost, stolen, or damaged/destroyed must be reported to the Office of the Registrar General immediately. Found birth certificates or certified copies of Birth Registration must be returned to the Office of the Registrar General immediately or delivered to a police or lost and found service.
Instruction #7 Not more than one Birth Certificate and one Certified Copy of a Birth Registration may be issued.
Instruction #8 Application for Reconsideration If your application for a Birth Certificate or Certified Copy of Birth Registration is refused, you may apply in writing to the Deputy Registrar General for your application to be reconsidered. You must provide your full name, mailing address, phone number, name of the person whose Birth Certificate or Certified Copy of Birth Registration is being applied for, file number of the application and reasons why your application should be reconsidered.
Instruction #9 Safeguarding your Certificates Please remember that it is important to keep your Birth Certificate in a secure location such as a safety deposit box and not in your wallet. By keeping it in a safe place, you are doing your part to protect your identity.
Instruction #10 Father The father’s information must be included on this application if the information appears on the child’s original birth registration.
The Office of the Registrar General holds records for births that happened in Ontario during the past 95 years.
To obtain older records, contact: Archives of Ontario 134 Ian Macdonald Boulevard Toronto ON M7A 2C5 800 668-9933 416 327-1600
Mail the Completed Request to: The Office of the Registrar General 189 Red River Road PO Box 4600 Thunder Bay ON P7B 6L8 Fax 807 343-7459
If you require faster service than 6-8 weeks, please apply online at www.serviceontario.ca