Government of Ontario: ServiceOntario

Application for Post Adoption Birth
Information Under Section 48.1 or
48.2 of the Vital Statistics Act

Please mail your completed form to the ServiceOntario
Office of the Registrar General
PO Box 9000
Thunder Bay ON  P7B 0A5

If you have any questions, please call
Within North America: 1 800 461-2156
In Toronto or Internationally: 416 325-8305


Important
Please read through the instructions thoroughly before completing this form.
Please print clearly in blue or black ink.

Section A - Applicant Information



Mailing Address at which correspondence from this office regarding
this application can be mailed to you:









*Telephone No.

* A telephone number may be used by this office to contact you regarding this application. If you do not wish to be contacted by telephone, do not include a telephone number.

Section B - Service Requested

Service Requested: Disclosure of adoption related information under section 48.1 or 48.2 of the Vital Statistics Act.

Please Identify if you are



Please complete

years old.

Section C - Information about Adopted Person AFTER Adoption



Sex    



Has the person named above ever had a legal name change?
If “Yes” provide details below.
  


Place of Birth of Adopted Person

 






Place of Birth of Adoptive Mother or Father






Place of Birth of Adoptive Father or Mother

Section D - Information about Adopted Person BEFORE Adoption



Sex    


Place of Birth of Adopted Person






Place of Birth of Mother or Father






Place of Birth of Father or Mother

Application for Post Adoption Birth Information
Under Section 48.1 or 48.2 of the Vital Statistics Act

As the applicant, you must sign and date this page in order for the application to be processed.

Making a false statement

On conviction, a person who willfully makes a false statement in this application is liable to a fine of not more than $50,000 or to imprisonment for a term of not more than two years less a day or both.

Section E - Signed Statement by the Applicant

I certify that the information given on this application form is true and correct to the best of my knowledge and belief.

I am aware that it is an offence to wilfully make a false statement on this form.



The information provided on this form is collected and may be used to determine your entitlement to and provide the service requested, search for and provide copies of the registered Statement or Withdrawal, and for adoption disclosure, statistical and research purposes, in accordance with the Vital Statistics Act, R.S.O. 1990, c. V.4 and for law enforcement purposes.

You may direct enquires regarding collection of this information to: Supervisor, ServiceOntario Call Centre, Contact Centre Service Branch, 5775 Yonge Street, Toronto ON M3M 3E6 or call 1 800 461-2156 in North America or 416 325-8305 in Toronto and Internationally.

If you are an adopted person who is applying for disclosure, you may be entitled to receive the following:

If you are a birth parent of an adopted person who is applying for disclosure, you may be entitled to receive information about the adopted person and yourself contained in the following documents: