523
FORM NO. 5.
[8. 13 (1).]
Declaration for altering or adding to the name of a child.
I (Name)
(Address)
(Description)
Parent or guardian] of the child of
and
the
day of
whose birth was registered on
under the
name (s) of
do solemnly, sincerely and
truly declare that I desire
(a) to add the name (s) of...
name (s).
Strike out either (a) or (b) as required.
:
(b) to alter the above-mentioned name(s) to
Before me,
(Signed).
(Signed.) A.B.,
Parent [or Guardian).
Registrar.
to the above-mentioned
I (Name)
(Address)
FORM NO. 6.
Declaration of name of child.
(Description)
Parent or guardian of the child of
and
on the
day of
(s. 13 (1).]
whose birth was registered
without a name, do solemnly, sincerely and truly declare that the
said child has received the name(s) of
and that
I desire that the said name(s) shall be added to the register.
Before me.
(Signed.)
(Signed.) A.B., Parent [or Guardian].
Registrar.
FORM No. 7.
[s. 18 (2).]
Certificate of registration of alteration of name of child.
I, A.B., Registrar for Deputy or Assistant Registrar of Births and Deaths, do hereby certify that the name for names of
by which a child of one C.D. and E.F. was registered on the
day of
register book.
>
19 has [or have been altered to
and that such alteration has been entered in the
Dated the
Fee $1.
day of
19
•
(Signed.) A.B., a registrar of Births and Deaths.