CAP. 174]

I (Name)
(Address)

Births and Deaths Registration.

FORM 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.

(Signed.)
A.B.,
Parent [or Guardian.]

Before me.

(Signed.)
Registrar.

FORM 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
has [or have] been altered to
and that such alteration has been entered in the
register book.

Dated the
day of
19
(Signed.)
Fee $1.
A.B., a Registrar of Births and Deaths.

FORM 8.

[s. 13 (2).]

Certificate of registration 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
has [or have] been given to the child of one C.D. and E.F. whose birth was registered on the
day of
and that such name or names has [or have] been entered in the register book.

Dated the
day of
19
(Signed.) A.B., a Registrar of Births and Deaths.
Fee $1.

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