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FORM NO. 5.
[s. 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
Strike out
(a) to add the name (s) of..
either (a) or (b) as required.
to the above-mentioned
name (s).
:.
(b) to alter the above-mentioned name(s) to
Before me,
(Signed).
(Signed.) A.B.,
Parent [or Guardian].
I (Name)
FORM NO. 6.
Declaration of name of child.
(Address)
(Description)
Parent [or guardian] of the child of
and
on the
day of
Registrar.
(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. 13 (2).]
Certificate of registration of alteration of name of child.
I, A.B., Registrar [or Deputy or Assistant Registrar of Births and Deaths, do hereby certify that the name [or names] of by which a child of one C.D. and E.F. was registered on the day of
7
19 has [or have] been altered to and that such alteration has been entered in the
register book.
Dated the
day of
19
,
(Signed.) A.B., a registrar of Births and Deaths.
Fee $1.