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\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 1984 \endash  1 July 1984}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 1 Title
\par 2 Interpretation}{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\faauto\rin0\lin0\itap0\pararsid5654494 {\cf17\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 PART 1
\par REGISTRATION GENERALLY}{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 
\par 3 Appointment of Registrar
\par 4 Place of registration of births and deaths}{\insrsid5654494 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 PART 2
\par REGISTRATION OF BIRTHS}{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 
\par 5 Form of Register of Births
\par 6 Particulars required for registration
\par 7 Persons responsible for reporting births
\par 8 Notification form
\par 9 Entry in the Register of Births
\par 10 Certificate of registration
\par 11 Births not previously registered
\par 12 Births occurring outside Niue
\par 13 Change of name
\par 14 Informant may sign Register of Births
\par 15 Entry of father\rquote s name
\par 16 Notice to attend on Registrar
\par 17 Legitimated children
\par 18 Late registration}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 PART 3
\par REGISTRATION OF DEATHS}{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 
\par 19 Form of Register of Deaths
\par 20 Particulars of deaths
\par 21 Persons responsible for reporting deaths
\par 22 Entry in Register of Deaths
\par 23 Informant may sign Register of Deaths
\par 24 Certificate by medical practitioner
\par 25 Deaths not attended
\par 26 Failure by medical practitioner to give}{\insrsid5654494  }{\insrsid5654494\charrsid5654494 certificate
\par 27 Notice by Minister of religion}{\insrsid5654494 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 PART 4
\par GENERAL PROVISIONS}{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9459652 {\insrsid5654494\charrsid5654494 
\par 28 Registers open to public
\par 29 Issue of certified copy for official use
\par 30 Evidence of entries
\par 31 Failure to supply required particulars
\par 32 Fees
\par 33 Custody of Registers
\par 34 Correction of errors
\par 35 Regulations to apply to stillborn child
\par 36 Failure of Registrar to register information
\par 37 Discretion of Registrar}{\insrsid5654494 
\par }{\insrsid5654494\charrsid5654494 
\par SCHEDULES
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494 ________________________
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 1 Title 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 These are the Births and Deaths Registration Regulations 1984. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 2 Interpretation 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 In these Regulations \endash  }{\insrsid5654494 
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 \'93informant\'94 means any person required by these Regulations to furnish to the Registrar particulars of a birth o
r death, as the case may be; }{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 \'93register\'94 means the Register of Births or the Register of Deaths, as the case may be; }{\insrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 \'93Registrar\'94 means the Registrar appointed under these Regulations and includes a Deputy Registrar so appointed. }{
\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494 PART 1
\par }{\insrsid5315720\charrsid5654494 REGISTRATION GENERALLY}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 3 Appointment of Registrar }{\b\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 There shall be appointed under Part VI of the Constitution such fit and proper persons as may be required to be Registrar and Deputy Registrar. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 4 Place of registration of births and deaths 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 All births and deaths occurring in Niue shall be registered by the Registrar whose office is in Alofi. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 PART 2}{\insrsid5654494 
\par }{\insrsid5315720\charrsid5654494 REGISTRATION OF BIRTHS}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 5 Form of Register of Births }{\b\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 The Register of Births shall be in form 1 in Schedule 1. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 6 Particulars required for registration 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) For the purpose of these Regulations, the following particulars of a birth occurring in Niue shall be furnished to the Registrar \endash  }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (a) The date and place of birth; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) The christian or first name and sex of the child; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (c) The names of the fathe
r and mother respectively; when and where married, ages, place of birth, place of residence and occupations; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(d) The description of the father and mother (race to be stated in full) [For example, Europeans, Niuean, half-European, half-Niuean]; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (e) The name, address, occupation and relationship of the informant to the child; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (f) The date of registration. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) The particulars of births specified in paragraph (1) shall be furnished to the Registrar within 14 days after the birth of the child. 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 7 Persons responsible for reporting births 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) The following persons shall be responsible for furnishing to the Registrar particulars of births specified in regulation 6, namely \endash  }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(a) In the case of a birth occurring in the public hospital, the midwife, nursing sister or nurse-in-charge at the time of birth; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) In the case of a birth occurring outside of hospital, the father or mother of the child; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (c) Every occupier of the house or building in which the child was born; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (d) Any person present at the birth of the child. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) If any of the persons specified in paragraph (1) duly furnishes the required information, the others of those persons shall thereupon be freed from the obligation of doing so. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 8 Notification form 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 The notification form shall be in form 2 in Schedule 1. }{\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 9 Entry in Register of Births 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) Upon receipt of the particulars of birth of any child born in Niue the Registrar shall enter those particulars in the Register of Births. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 
(2) The Registrar may, notwithstanding that the full particulars required by these Regulations have not been furnished, upon being satisfied with the particulars furnished to him, register the birth of any child in the Register of Births. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 10 Certificate of registration }{\b\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 The certificate of registration shall be in form 3 in Schedule 1. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 11 Births not previously registered 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Notwithstanding anything in these Regulations, the Registrar may register the birth of any person born in Niue, whether before or after the commencing of these Regulations, whose birth has not been previously registered. 
}{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 12 Births occurring outside Niue 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 
(1) Where a child born out of Niue arrives and before attaining the age of 24 months, and the parents or other persons having lawful charge of the child are ordinarily resident in or about to take up their abode in Niue, a Registrar, on application being
 made at any time within six months from the date of the child\rquote 
s arrival by one of the parents, or by a person having lawful charge, shall register the birth of the child in the manner provided by these Regulations for the registration of births taken place in Niue. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Documentary evidence as to the date of birth of the child must be submitted together with the application for the registration of such a birth. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (3) The Registrar shall not refuse the application of any person for registration of the birth of the child born out of Niue on the ground of the }{\insrsid5797775 non-}{\insrsid5797775\charrsid5654494 production}{
\insrsid5315720\charrsid5654494  of documentary evidence alone. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 13 Change of name 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) Any person whose birth is registered in Niue, and who has attained the age of 21 years or is married or has at any time been marrie
d, may change his or her name, whether as to his/her surname or as to any first name or christian name. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5654494 (2)
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(a) The parents of any child who has not attained the age of 21 years and has never been married may change the name of the child, whether as to his/her surname or as to any first or christian name. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) Where the child has attained the age of 18 years his/her consent shall be required to the change of name. }{
\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (c) For the purposes of this paragraph the term \'93parents\'94 \endash  }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li1440\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (i) Where one of the paren
ts has deserted the child or is dead or unknown or missing or of unsound mind, means the other parent; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li1440\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(ii) Where the child has been adopted, according to the law in force for the time being, means the adoptive parents or one of them; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li1440\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (iii) Where the child has a legal guardian, means or includes that guardian. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5654494 (3)
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (a) For the purpose of this Regulation, any change of name shall be effected by Deed Poll in form 4. }{\insrsid5315720 

\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(b) Any application at any time for the change of name shall be restricted in all respects to not more than 2 applications except in special circumstances and subject to the discretion of the Registrar whose decision shall be final. }{\insrsid5315720 

\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (4) Any change of name shall be registered at the Registrar\rquote 
s Office and the original registration amended accordingly subject always to the payment of the prescribed fee set out in Schedule 2 except where fees are being waived by the Registrar in case of hardship or other valid reasons. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (5) Every certificate of the date of birth issue under this clause shall show the name as changed and no other name and reference to the original name or names for identification purposes. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 14 Informant may sign Register of Births 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Upon completing all the entries in the Register of Births, the Registrar shall request the informant, if then present, to sign the entries but this condition is obligatory rather than compulsory. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 15 Entry of father\rquote s name 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Unless the informant states that the child is born in lawful wedlock or is the posthumous child of lawfully married persons or unless the father together with the mother attends personally at the Registrar\rquote 
s Office and make admission that he is the father of the child and the mother agrees to the father\rquote 
s name being entered in the Register of Births, or unless an affiliation order has been made under Part 23 of the Niue Act 1966 in respect of the child, the Registrar shall not enter in the Register of Births the name of any person as the father
 of the child. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 16 Notice to attend on Registrar 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Notwithstanding that the birth of any child has not been registered within the period specified in regulation 5(2), the Registrar may after one month and not later than 6 months after the birth of the chi
ld, by notice in writing (form 5) requires the parent or parents or some person present at the birth of the child to attend personally at his office within the time specified in the notice and give information of the particulars required to be registered,
 and the Registrar shall thereupon register the birth according to the information given. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 17 Legitimated children 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5654494 (1)
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (a) Upon the intermarriage of parents o
f an illegitimate child born in Niue and upon application being made to the Registrar in whose office the birth of the child is registered, the Registrar may register the particulars of the father. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) Satisfactory evidence by statutory declaration or ot
her such evidence he may deem necessary of the paternity of that child shall have been first given to the Registrar. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Notwithstanding anything in paragraph (1) every case where it is not practical for the natural parents to attend personally at the of
fice of the Registrar in whose office the birth was registered the application be made in writing with support documentary evidence to the Registrar who may authorise the registration of the particulars relating to the father. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 18 Late registration 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Notw
ithstanding the time restriction imposed by regulation 12 the Registrar may authorise the registration of any birth which occurred out of Niue provided that satisfactory evidence by statutory declaration or other evidence may be deemed necessary as to the
 birth of the child irrespective as to whether or not the birth of the child has been registered at the country where it originally occurred or took place. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494 PART 3
\par }{\insrsid5315720\charrsid5654494 REGISTRATION OF DEATHS}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 19 Form of Register of Deaths 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 The Register of Deaths shall be in form 6. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 20 Particulars of deaths }{\b\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) For the purpose of these Regulations, the following particulars of deaths occurring in Niue shall be furnished to the Registrar \endash  }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (a) The date and place of death; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) The name and residence of the deceased; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (c) The sex of the deceased; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (d) The age of the deceased; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (e) If married, the name of the deceased\rquote s husband or wife; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (f) The number and sex of children living (if any); }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (g) The cause of death certified by a medical officer who attended the deceased during last illness; }{\insrsid5315720 

\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (h) The duration of illness of the deceased (if known); }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (i) The name of medical practitioner giving the certificate and brief description of qualifications; }{\insrsid5315720 

\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (j) The date when medical practitioner last saw the deceased; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(k) The names and descriptions of the father and mother of the deceased (race to be stated in detail). For example, European, Niuean, half European, and half Niuean and their place of residence; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(l) The name, description, place or residence, occupation and degree of relationship of informant (if any) to the deceased; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (m) The date of registration. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) The particulars of deaths specified in paragraph (1) shall be furnished to the Registrar within 24 hours after death occurred. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 21 Persons responsible for reporting deaths 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) The following persons or officer shall be responsible for furnishing the particulars of deaths specified in regulation 20, namely \endash  }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (a) The medical practitioner by issuing a death certificate duly executed under his hand; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) Every occupier of the house or building in which the death took place; }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (c) Any person present at the death. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) If any of the persons or medical officer specified herein duly furnishes the required information, the others of those persons or officers shall thereupon be freed from the obligation of doing so. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 22 Entry in Register of Deaths 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) Upon the receipt of the particulars of death of any person dying in Niue, the Registrar shall enter those particulars in the Register of Deaths. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Notwithstanding that the full particulars required by these Regulations have not been furnished, the Registrar, upon bein
g satisfied with the particulars furnished to him, may register the death of any person in the Register of Deaths. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 23 Informant may sign Register of Deaths 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Upon completing the entries in the Register of Deaths, the Registrar shall request the informant, if then present, to sign the entries, but the informant shall not be obliged to sign the entries. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 24 Certificate by medical practitioner 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) On the
 death of any person who has been attended during his/her last illness by a medical practitioner, that medical practitioner shall sign and deliver or cause to be delivered to the Registrar a certificate in form 7 in Schedule 1 stating to the best of his k
nowledge and belief the causes of death (both primary and secondary) and the duration of the last illness of the deceased. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) The particulars set forth in the said certificate shall be entered, together with the name of the certifying medical practitioner in the Register of Deaths. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 25 Deaths not attended 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) On the death of any person in Niue where there is for the time being a Director of Health and that person has not been attended by a medical practitioner as aforesaid, the Director of Health or hi
s deputy, as the case may be, or other medical practitioner authorised by him in that behalf, shall sign and deliver, or cause to be delivered, to the Registrar a certificate in form 8 in Schedule 1, stating to the best of his knowledge and belief the cau
se of death (both primary and secondary) of the deceased. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) }{\insrsid5654494 
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(a) For the purpose of enabling him to issue such a certificate, the Director of Health, and in his absence the Deputy Director of Health, shall have the right to make such examination or who
 without reasonable cause obstructs or interferes with the Director of Health or his deputy, in conducting such an examination, is liable to a fine not exceeding 1 penalty unit. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) If any relative of the deceased objects to such an examination being mad
e, the Director of Health or the deputy acting on his behalf, may appeal to Cabinet whose decision shall be final. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5654494 (3)
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(a) On the receipt by the Registrar of a medical certificate under the provision of this regulation, the Registrar shall issue to such person as he deems entitled thereto an authority for the burial of the deceased. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) Every such authority under his hand shall be in form 9 in Schedule 1. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (4) Where in any case to which paragraph (3) applies any person, without an authority in form 9 
being first obtained, bury or causes to be buried any person who has died in Niue, he is liable to a fine not exceeding 1 penalty unit. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 26 Failure by medical practitioner to give certificate 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Every medical practitioner required under regulations 24 and 
25 to issue a certificate in form 7 or form 8 in Schedule 1 concerning any death refuses or neglects to give that certificate, and any person to whom any such certificate is given who fails to deliver the certificate to the Registrar is liable to a fine n
ot exceeding 0.5 penalty units. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 27 Notice by Minister of religion 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Every Minister of religion or other person who performs any religious or funeral service for or at the burial of any dead body, or the person who conducts the burial of any dead body shal
l give or forward within 7 days written notice of the burial in form 10 in Schedule 1 to the Registrar. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 PART 4}{\insrsid5654494 
\par }{\insrsid5315720\charrsid5654494 GENERAL PROVISIONS}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 28 Registers open to public 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) The Registers to be kept under these Regulations shall at all reasonable times be open to the public for search on payment of the appropriate fee prescribed in Schedule 2. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) The Registrar shall, on the application of any person and on payment of the appropriate fee prescribed in Schedule 2, issue certificates of any entry made in the said Registers. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (3) Notwithstanding this regulation, the Registrar may dispense with the payment of any fee payable under these Regulations in cases of genuine hardship. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 29 Issue of certified copies for official use 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 
(1) Notwithstanding regulation 32, where a certified copy of any entry in a Register kept under these Regulations or a certificate as to any entry is required for the purposes of any Government Department, the Registrar shall issue th
e certified copy or special certificate in the prescribed form, free of charge. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Every certified copy or certificate issued under paragraph (1) shall indicate the purpose for which it was issued and shall not be available for any other purpose, and sh
all be retained by the Department for whose purposes it was required. 
\par }{\b\insrsid5315720\charrsid5654494 
\par 30 Evidence of entries 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 A certified copy of or a certificate relating to any entry in a Register, made or given and purporting to be issued and signed by the Registrar and sealed and 
stamped with his seal, shall be received in any court as prima facie evidence of the birth or death to which it relates. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 31 Failure to supply required particulars 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) Every person required by these Regulations to furnish particulars in respect of any m
atter who, without sufficient cause, fails to furnish those particulars is liable for a first offence to a fine not exceeding 0.5 penalty units and for a second or any subsequent offence to a fine not exceeding 0.5 penalty units and any person who wilfull
y furnishes false particulars is liable to a fine not exceeding 1 penalty unit. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Where any person who is convicted under these Regulations for failure to furnish the particulars required for the registration of any birth or death, the court shall direc
t the Registrar forthwith to register the birth or death, and if the birth or death has not been previously registered the Registrar shall register the birth or death accordingly. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 32 Fees 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 For the purposes of these Regulations, the fees specified in Schedule 2 shall be payable to the Registrar as the case may require. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 33 Custody of Registers 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) The Registers shall be safely kept by the Registrar in whose custody they are placed, and shall be deemed to be the property of the Crown. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Upon the death, dismissal, transfer or resignation of the Registrar, the custody of those Registers shall pass to his successor in office. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 34 Correction of errors }{\b\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) Any clerical error or any error of fact or substance or any omission of any material fact in any Register may be corrected by the Registrar as the case may require. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2)}{\insrsid5654494 
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(a) Instead of making any correction as aforesaid, the Registrar may, if he thinks fit, direct a new entry to be made in the Register. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) Any such entry shall contain a reference to the original entry, and the original entry shall contain a reference to
 the new entry together with the date of the correction. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
(c) Any such new entry shall be signed by a person who is required under these Regulations to give the particulars of birth or death, as the case may be, or by such other persons as may be authorised by the Registrar. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (3) For the purpose of this regulation, the Registrar may require to be produced a statutory declaration and such other evidence as to the facts as he considers necessary. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (4) Except as otherwise provided in these Regulations, no alteration in any Register shall be made. 
\par 
\par }{\b\insrsid5315720\charrsid5654494 35 Regulations to apply to stillborn child 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1)}{\insrsid1190328 
\par 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid1190328 {\insrsid5315720\charrsid5654494 
(a) The provisions of these Regulations relating to the registration of births shall apply in the case of a stillborn child, but a Registrar may dispense with the registration of the death of any such child. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1190328 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid1190328 {\insrsid5315720\charrsid5654494 
(b) A stillborn child shall be a child that has issued from its mother after the expiration of the 28 weeks of pregnancy and was not alive at the time of such issue. }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (2) Particulars required for registration of a stillborn child shall be entered on a separate Register kept specially for that purpose. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 36 Failure of Registrar to register information }{\b\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Where \endash  }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (a) The Registrar refuses or without reasonable cause omits to register any birth or any death of which he had}{
\insrsid5654494  due notice and information; or}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \ql \li720\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 (b) Any person having the custody of any Register or certified copy thereof, or any part thereof, negligently los
es or injures the same, or negligently allows the same to be injured while in his keeping \endash  
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
\par he is liable to a fine not exceeding 1 penalty unit. }{\insrsid5315720 
\par }{\b\insrsid5654494\charrsid5654494 
\par }{\b\insrsid5315720\charrsid5654494 37 Discretion of Registrar 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Where for any sufficient cause shown to the satisfaction of the Registrar any 
act, matter, or thing required by these Regulations cannot be done within the time limited by or in strict compliance with the conditions imposed by these Regulations, it shall be sufficient if that act, matter, or thing is done within a reasonable time t
hereafter, or if the conditions imposed are complied with so far as is reasonably possible. }{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash 
\endash \endash \endash \endash \endash }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\trowd \irow0\irowband0\ts11\trqc\trgaph108\trrh328\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth6730\clshdrawnil \cellx6622\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 SCHEDULES\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\cf18\insrsid5315720\charrsid5654494 \trowd \irow0\irowband0\ts11\trqc\trgaph108\trrh328\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 
\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth6730\clshdrawnil \cellx6622\row }\trowd \irow1\irowband1
\ts11\trqc\trgaph108\trrh360\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth6730\clshdrawnil \cellx6622
\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 SCHEDULE 1\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\cf18\insrsid5315720\charrsid5654494 \trowd \irow1\irowband1\ts11\trqc\trgaph108\trrh360\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr
\brdrtbl \cltxlrtb\clftsWidth3\clwWidth6730\clshdrawnil \cellx6622\row }\trowd \irow2\irowband2\ts11\trqc\trgaph108\trrh390\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrtbl \clbrdrl
\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1720\clshdrawnil \cellx1612\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth4273\clshdrawnil \cellx5884\clvertalt\clbrdrt
\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth738\clshdrawnil \cellx6622\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 Reg 5
\cell Form 1\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 No. \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\cf18\insrsid5315720\charrsid5654494 \trowd \irow2\irowband2\ts11\trqc\trgaph108\trrh390\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr
\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1720\clshdrawnil \cellx1612\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth4273\clshdrawnil \cellx5884\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb
\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth738\clshdrawnil \cellx6622\row }\trowd \irow3\irowband3\ts11\trqc\trgaph108\trrh330\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1720\clshdrawnil \cellx1612\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth4273\clshdrawnil \cellx5884
\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth738\clshdrawnil \cellx6622\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\insrsid5315720\charrsid5654494 \cell }\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 NIUE\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 
\trowd \irow3\irowband3\ts11\trqc\trgaph108\trrh330\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1720\clshdrawnil \cellx1612\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth4273\clshdrawnil \cellx5884\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl 
\clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth738\clshdrawnil \cellx6622\row }\trowd \irow4\irowband4\lastrow \ts11\trqc\trgaph108\trrh198\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt
\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1720\clshdrawnil \cellx1612\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth4273\clshdrawnil \cellx5884
\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth738\clshdrawnil \cellx6622\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\insrsid5315720\charrsid5654494 \cell }\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 REGISTRATION OF BIRTH\cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 
\trowd \irow4\irowband4\lastrow \ts11\trqc\trgaph108\trrh198\trleft-108\trftsWidth3\trwWidth6730\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1720\clshdrawnil \cellx1612\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth4273\clshdrawnil \cellx5884\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl 
\clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth738\clshdrawnil \cellx6622\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
\par }\trowd \irow0\irowband0\ts11\trgaph108\trrh288\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 
\clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr
\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 Child \cell Particulars \cell }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\cf18\insrsid5315720\charrsid5654494 \trowd \irow0\irowband0
\ts11\trgaph108\trrh288\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow1\irowband1\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 1 Date of Birth: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow1\irowband1
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow2\irowband2\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 2 Place of Birth: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow2\irowband2
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow3\irowband3\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 3 Christian and Surname: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow3\irowband3
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow4\irowband4\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 4 Sex: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow4\irowband4
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow5\irowband5\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 Parents \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow5\irowband5
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow6\irowband6\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 5 When Married: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow6\irowband6
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow7\irowband7\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 6 Where Married: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow7\irowband7
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow8\irowband8\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 Father \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow8\irowband8
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow9\irowband9\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 7 Name and Surname: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow9\irowband9
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow10\irowband10\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 8 Age and Race: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow10\irowband10
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow11\irowband11\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 9 Place of Birth and Residence: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow11\irowband11
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow12\irowband12\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 10 Occupation: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow12\irowband12
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow13\irowband13\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 Mother \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow13\irowband13
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow14\irowband14\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 11 Name and Surname: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow14\irowband14
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow15\irowband15\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 12 Age and Race: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow15\irowband15
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow16\irowband16\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 13 Place of Birth and Residence: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow16\irowband16
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 14 Occupation \cell }{\insrsid5315720\charrsid5654494 
\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow17\irowband17
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow18\irowband18\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 Informant \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow18\irowband18
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow19\irowband19\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 15 Signature: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow19\irowband19
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 16 Residence: \cell }{\insrsid5315720\charrsid5654494 
\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow20\irowband20
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow21\irowband21\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 17 Occupation: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow21\irowband21
\ts11\trgaph108\trrh323\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalb\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow22\irowband22\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc
\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 18 Relationship to Child: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow22\irowband22
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {\cf18\insrsid5315720\charrsid5654494 19 Date of Registration: \cell }{
\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 \trowd \irow23\irowband23
\ts11\trgaph108\trrh320\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb
\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 
\cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\trowd \irow24\irowband24\lastrow \ts11\trgaph108\trrh330\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 
\clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5654494 {
\cf18\insrsid5315720\charrsid5654494 20 Signature of Registrar: \cell }{\insrsid5315720\charrsid5654494 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid5315720\charrsid5654494 
\trowd \irow24\irowband24\lastrow \ts11\trgaph108\trrh330\trleft360\trftsWidth3\trwWidth8047\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblrsid14179988 \clvertalc\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl
\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 \clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth3932\clshdrawnil \cellx4292\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf18 \clbrdrl\brdrs\brdrw10\brdrcf18 \clbrdrb\brdrs\brdrw10\brdrcf18 
\clbrdrr\brdrs\brdrw10\brdrcf18 \cltxlrtb\clftsWidth3\clwWidth4115\clshdrawnil \cellx8407\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
\par I certify that the above particulars are a true record of the birth of recorded}{\insrsid5654494 
\par }{\insrsid5315720\charrsid5654494  this }{\insrsid5654494 \'85\'85\'85\'85..}{\insrsid5315720\charrsid5654494 day of }{\insrsid5654494 \'85\'85\'85\'85..}{\insrsid5315720\charrsid5654494 20 }{\insrsid5654494 \'85\'85.}{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Caution \endash  Any person who (1) falsifies any of the particulars on this certificate; or (2) uses it as true knowing it to be false, is liable to prosecution under the Births and Deaths Registration Regulations 1984. 
}{\insrsid5315720 
\par }{\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash 
\endash }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 Form 2}{\insrsid13505497 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 Issue No. 001 }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5654494\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 BIRTHS REGISTRATION REGULATIONS 1984}{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 (Reg 8)}{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 NOTIFICATION FORM}{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 (To be delivered or posted to the Registrar of Births within 14 days after the birth)}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 The Registration of Births Alofi, Niue }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 A TAKE NOTICE that a female/male child was born at Lord Liverpool Hospital on ________/________/20__ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Full name of mother:}{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 Village of residence:}{\insrsid13505497 
\par }{\insrsid1190328 
\par }{\insrsid5315720\charrsid5654494 Signature of Nurse/Midwife/Nursing Sister in attendance and date:}{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 ________/________/20__ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 IF CHILD STILLBORN complete the following and delete where not applicable. }{\insrsid5315720 
\par }{\insrsid1190328\charrsid5654494 
\par }{\insrsid13505497 (a) }{\insrsid5315720\charrsid5654494 Stillborn \endash  born to _______________________of________________________ on ________/________/20__ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (b) Report pending/Report not required 
\par }{\insrsid5315720 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid13505497 ___________________________}{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Signature of Medical Practitioner }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 C FOR OFFICE USE ONLY }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (a) Registered by: ________________________________________ 
\par (b) Notice to parents sent on ________/________/20__ 
\par (c) All actions completed on ________/________/20__ 
\par (d) Registration No.: ______________________________________ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid13505497 ________________________}{\insrsid5315720\charrsid5654494 
\par Signature of officer responsible }{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 for the final actions }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid13505497\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 Form 3}{\insrsid13505497 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 Issue No.___________________}{\insrsid13505497 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1190328 {\insrsid1190328 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 CERTIFICATE OF REGISTRATION}{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 (Reg 10)}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 THIS IS TO CERTIFY that the birth of a male/female child born on ________/________/20__ has been registered in this office. }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Name of Child: }{\insrsid13505497 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\insrsid5315720\charrsid5654494 
\par }{\insrsid13505497\charrsid5654494 
\par }{\cf18\insrsid13505497\charrsid5654494 Registration No: }{\cf18\insrsid13505497 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\cf18\insrsid13505497\charrsid5654494 
\par }{\insrsid13505497\charrsid5654494 
\par }{\cf18\insrsid13505497\charrsid5654494 Name of mother: }{\cf18\insrsid13505497 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85..}{\cf18\insrsid13505497\charrsid5654494 
\par }{\insrsid13505497\charrsid5654494 
\par }{\cf18\insrsid13505497\charrsid5654494 Name of father: }{\cf18\insrsid13505497 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\cf18\insrsid13505497\charrsid5654494 
\par }{\insrsid13505497\charrsid5654494 
\par }{\cf18\insrsid13505497\charrsid5654494 Village of residence: }{\cf18\insrsid13505497 \'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85\'85}{\cf18\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 
\par Date of registration: ________/________/20__ }{\insrsid5315720 
\par }{\insrsid13505497 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid13505497 ________________}{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Deputy Registrar }{\insrsid13505497 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 Note: This is not a birth certificate but it can be used locally for school enrolment purposes, etc. }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 BIRTHS AND DEATHS REGULATIONS 1984}{\insrsid13505497 
\par }{\insrsid5315720\charrsid5654494 (Reg 13)}{\insrsid13505497 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1190328 {\insrsid1190328 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 Form 4}{\insrsid13505497 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13505497 {\insrsid5315720\charrsid5654494 CHANGE OF NAME BY DEED POLL}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (Full Name)\tab I,______________________________________________________ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (Full Address)\tab of _____________________________________________________ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (Occupation) ____________________________________________________ am desirous of abandoning and renouncing the use of the name of }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (Old Name) _______________________________________________________ I hereby absolutely abandon and renounce the use of the name }{\insrsid5315720 
\par }{\insrsid13505497 
\par __________________________________________________________________}{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 and HEREBY DECLARE that at all times here after }{\insrsid13505497 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (New Name)\tab I shall use and subscribe the name ________________________ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (Old Name)\tab 
in lieu of the name ____________________________ in all deeds and documents and in all acts and proceedings and in all ____ transactions and matters and things and upon all occasions, AND I HEREBY AUTHORISE all persons at all times
 hereafter to __ describe and address me by the name of }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (New Name) _______________________________________________________ IN WITNESS WHEREOF I have here subscribed the name of }{\insrsid13505497 
\par 
\par }{\insrsid5315720\charrsid5654494 (Old Name) ____________________________ and also my assumed name of }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid13505497 (New Name) }{\insrsid5315720\charrsid5654494 ______________________this ________ day of__________20___ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 SIGNED by the said _____________________________________ }{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 hereafter to be known as _______________________________________ }{\insrsid13505497\charrsid5654494 in the }{\insrsid13505497 
\par 
\par }{\insrsid13505497\charrsid5654494 presence of_________}{\insrsid13505497 _____________________________________________}{\insrsid5315720 
\par }{\insrsid13505497\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Signature: }{\insrsid13505497 _________________     _____________________________________}{\insrsid5315720 
\par }\pard \ql \li5040\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin5040\itap0\pararsid13505497 {\insrsid13505497\charrsid5654494 Old Name}{\insrsid13505497 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497 
\par _________________________     ______________________________________
\par 
\par }\pard \ql \li5040\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin5040\itap0\pararsid13505497 {\insrsid13505497\charrsid5654494 New Name}{\insrsid13505497 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13505497\charrsid5654494 
\par }{\insrsid13505497 Witness: __________________
\par Address: __________________
\par Occupation: _______________ }{\insrsid5315720\charrsid5654494 
\par }{\insrsid13505497 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13376446 {\insrsid5315720\charrsid5654494 Form 5}{\insrsid13376446 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13376446 {\insrsid5315720\charrsid5654494 BIRTHS REGISTRATION REGULATIONS 1984
\par (Reg 16)}{\insrsid13376446 
\par }{\insrsid5315720\charrsid5654494 OFFICE OF REGISTRAR OF BIRTHS ALOFI NIUE}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13376446\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 To: ____________________________ }{\insrsid5315720 
\par }{\insrsid13376446 _________________________________
\par _________________________________
\par }{\insrsid13376446\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 The birth of your child which occurred on the _____________________________ }{\insrsid5315720 
\par }{\insrsid13376446\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 has not yet been registered at my office. }{\insrsid5315720 
\par }{\insrsid13376446\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 You are therefore reminded that registration should be effected on or before the ________ day of ________20__ }{\insrsid5315720 
\par }{\insrsid13376446 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13376446 {\insrsid13376446 ___________________}{\insrsid13376446\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Registrar }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid13376446\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 NOTE:\tab If the birth is not registered within 14 days the persons responsible for registration render themselves LIABLE TO PROSECUTION. }{\insrsid5315720 
\par }{\insrsid13376446\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13376446 {\insrsid5315720\charrsid5654494 REGISTER OF DEATHS}{\insrsid13376446 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13376446 {\insrsid5315720\charrsid5654494 Form 6 }{\insrsid14179988 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid5315720\charrsid5654494 (Reg 19)}{\insrsid13376446 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13376446 {\insrsid5315720\charrsid5654494 Registered at Alofi, in the}{\insrsid13376446  Island of Niue}{\insrsid5315720\charrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 Entry NO: }{\insrsid5315720 
\par }{\insrsid15955881\charrsid5654494 
\par }\trowd \irow0\irowband0\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 DECEASED \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow0\irowband0
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 1. Date of death: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow1\irowband1\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 2. Place of death: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow2\irowband2\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 3. Name: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow3\irowband3
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 4. Residence: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow4\irowband4
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 5. Sex: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow5\irowband5
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 6. Age: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow6\irowband6
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 7. Name of husband or wife (if any): \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow7\irowband7\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 8. Number and sex of children living (if any): \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 \trowd \irow8\irowband8\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 9. Causes of death: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow9\irowband9\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 10. Duration of last illness: \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow10\irowband10\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 11. Name of medical practitioner giving certificate and his qualifications (if\line any):\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow11\irowband11\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 
\trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15955881\yts35 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 12. Date when medical practitioner last saw deceased:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow12\irowband12\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 
\trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 PARENTS OF DECEASED\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow13\irowband13\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 
\trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15955881\yts35 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 Mother\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 \trowd \irow14\irowband14\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 13. Name:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow15\irowband15
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 14. Residence:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow16\irowband16\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 15. Description:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow17\irowband17\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 Father\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow18\irowband18
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 16. Name:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow19\irowband19
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 17. Residence:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow20\irowband20\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 18. Description:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow21\irowband21\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 INFORMANT\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow22\irowband22
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 19. Signature:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow23\irowband23\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 20. Residence and occupation:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow24\irowband24\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 21. Degree of relationship (if any) to deceased:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 \trowd \irow25\irowband25\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 REGISTRAR\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 \trowd \irow26\irowband26
\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 22. Date of registration:\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid15955881\charrsid15955881 
\trowd \irow27\irowband27\ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid14048381\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid15955881 23. Signature of Registrar:}{\insrsid15955881\charrsid5654494 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid15955881\charrsid5654494 \trowd \irow28\irowband28\lastrow \ts35\trgaph108\trleft0\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8414\clshdrawnil \cellx8414\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
\par I solemnly declare that to the best of my knowledge and belief the foregoing particulars are true in every respect. }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12020910 {\insrsid5315720\charrsid5654494 \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash 
\endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash  }{\insrsid12020910 
\par }{\insrsid5315720\charrsid5654494 Signature of Registrar }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid12020910\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12020910 {\insrsid5315720\charrsid5654494 Form 7}{\insrsid12020910 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12020910 {\insrsid5315720\charrsid5654494 BIRTHS AND DEATHS REGISTRATION REGULATIONS 1984}{\insrsid12020910 
\par }{\insrsid5315720\charrsid5654494 (Reg 20)}{\insrsid12020910 
\par }{\insrsid5315720\charrsid5654494 MEDICAL CERTIFICATE OF CAUSES OF DEATH}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 A\tab Particulars as to deceased: }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Name of deceased: _________________________________________________ }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Sex: ____________________________Aged as stated to me: _______________ }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Date of death: __________________________, day of____________ 20_______ }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Place of death; }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Last seen by me: _________________________, day of __________ 20_______ }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 B\tab Causes of death (State clearly in full and not in abbreviated form) }{\insrsid5315720 
\par }{\insrsid12020910\charrsid5654494 
\par }\trowd \irow0\irowband0\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8460\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4058\clshdrawnil \cellx4598\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4402\clshdrawnil \cellx9000
\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8797692\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid12020910\charrsid12020910 1 Disease, injury or complication directly l
eading to death:\cell  (a) ____________________________ ______________________________ \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid12020910\charrsid12020910 \trowd \irow0\irowband0\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8460\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4058\clshdrawnil \cellx4598\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4402\clshdrawnil \cellx9000
\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8797692\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid12020910\charrsid12020910 
due to, or as a consequence of: due to, or as a consequence of:\cell (b) ____________________________\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid12020910\charrsid12020910 \trowd \irow1\irowband1\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8460\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4058\clshdrawnil \cellx4598\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4402\clshdrawnil \cellx9000
\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8797692\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid12020910\charrsid12020910 
due to, or as a consequence of: due to, or as a consequence of:\cell (c) ____________________________\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid12020910\charrsid12020910 \trowd \irow2\irowband2\lastrow \ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8460\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4058\clshdrawnil \cellx4598\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth4402\clshdrawnil \cellx9000
\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid12020910 
\par }{\insrsid5315720\charrsid5654494 2.\tab Other significant factors: ______________________________ }{\insrsid5315720 
\par }{\insrsid8404674\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 3.\tab Appropriate between onset and death: ____________________________ 
\par 
\par C\tab Additional data (delete box not applicable) }{\insrsid5315720 
\par }{\insrsid8404674\charrsid5654494 
\par }\trowd \irow0\irowband0\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil \cellx6660
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid6638608\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid8404674\charrsid8404674 1.\tab Did you see the body after death: \cell \cell }\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8404674\yts35 {\insrsid8404674\charrsid8404674 Yes\cell No\cell }\pard\plain 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid8404674\charrsid8404674 \trowd \irow0\irowband0\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil \cellx6660
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid6638608\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid8404674\charrsid8404674 2.\tab Post mortem\cell (a) not intended to be held\cell }\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8404674\yts35 {\insrsid8404674\charrsid8404674 Yes\cell No\cell }\pard\plain 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid8404674\charrsid8404674 \trowd \irow1\irowband1\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil \cellx6660
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\row }\trowd \irow2\irowband2\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv
\brdrs\brdrw10 \trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvmgf\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 
\clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil 
\cellx6660\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid6638608\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid2961437\charrsid8404674 \cell (b) held and results available\cell }\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8404674\yts35 {\insrsid2961437\charrsid8404674 Yes\cell No\cell }\pard\plain 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid2961437\charrsid8404674 \trowd \irow2\irowband2\ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvmgf\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil \cellx6660
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\row }\trowd \irow3\irowband3\lastrow \ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 
\trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvmrg\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil \cellx6660\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 
\clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid6638608\yts35 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid2961437\charrsid8404674 \cell (c) being or to be held\cell }\pard \qc \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8404674\yts35 {
\insrsid2961437\charrsid8404674 Yes\cell No\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid2961437\charrsid8404674 
\trowd \irow3\irowband3\lastrow \ts35\trgaph108\trleft540\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8640\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvmrg\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3021\clshdrawnil \cellx3561\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3099\clshdrawnil \cellx6660
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx7920\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr
\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx9180\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
\par I, ____________________________________________certify that I was in medical attendance during the abovenamed deceased\rquote s last illness and the particulars quoted above are true to the best of my knowledge and belief. }{\insrsid5315720 
\par }{\insrsid5661272\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 (1) ___________________ (2) ______________________ (3) __________________ Signature of Medical Officer  }{\insrsid5661272            }{\insrsid5315720\charrsid5654494 Qualifications }{\insrsid5661272 
                                 }{\insrsid5315720\charrsid5654494 Date }{\insrsid5315720 
\par }{\insrsid5661272\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Note: Form 8 to be completed if Medical Practitioner did not attend the deceased during his/her last illness AND NOT THIS FORM }{\insrsid5315720 
\par }{\insrsid5661272\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 Form 8}{\insrsid5661272 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 CERTIFICATE OF DEATH BY MEDICAL OFFICER OF PERSON NOT ATTENDED BY A MEDICAL OFFICER}{\insrsid3040484 
\par }{\insrsid5315720\charrsid5654494 (Reg 20)}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5661272\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 TO THE REGISTRAR OF BIRTHS AND DEATHS, NIUE }{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 I, the undersigned, hereby certify that I have examined the body of __________ who is reported to have died at____________________on the ____________day of___________________ 20___________ }{\insrsid5315720 
\par }{\insrsid3040484\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 To the best of my knowledge and belief the causes of death were:}{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 Primary ______________________________________________________________}{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 Secondary ____________________________________________________________}{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 Witness by hand this____________day of_____________20____at _____________}{\insrsid5315720 
\par }{\insrsid3040484\charrsid5654494 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash 
\endash \endash \endash \endash \endash \endash \endash \endash \endash  }{\insrsid3040484 
\par }{\insrsid5315720\charrsid5654494 Medical Officer }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 Form 9}{\insrsid3040484 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 AUTHORITY TO BURY}{\insrsid3040484 
\par }{\insrsid5315720\charrsid5654494 (Reg. 25(3))}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 To _______________________________of _________________________ I }{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 ______________________________, the Registrar of Births and Deaths, Niue hereby }{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 authorise the burial of the body of _________________________who died }{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 at___________________________________________________________________}{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 _ on the ___________________day of _____________________20___________ }{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 Witness by hand this _________________________day of______________20 ____ }{\insrsid3040484 
\par 
\par }{\insrsid5315720\charrsid5654494 at ____________________}{\insrsid3040484 
\par 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494  \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash 
\endash \endash \endash \endash \endash \endash \endash \endash \endash  }{\insrsid3040484 
\par }{\insrsid5315720\charrsid5654494 Registrar }{\insrsid3040484 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 Please advise the deceased family that this death must be registered within one week}{\insrsid3040484 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 Form 10}{\insrsid3040484 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 CERTIFICATE AS TO BURIAL}{\insrsid3040484 
\par }{\insrsid5315720\charrsid5654494 (Reg 27)}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid3040484\charrsid5654494 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484 I, __________________,}{\insrsid5315720\charrsid5654494 of_________________}{\insrsid3040484 ___________________________,}{\insrsid5315720 

\par }{\insrsid3040484\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 hereby certify that the body of ___________________________________________ }{\insrsid5315720 
\par }{\insrsid3040484\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 was duly buried on the _______________day of _____________20 _______in my presence }{\insrsid5315720 
\par }{\insrsid3040484 
\par }\pard \qr \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid3040484 ______________________}{\insrsid3040484\charrsid5654494 
\par }{\insrsid5315720\charrsid5654494 Minister and Denomination }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash \endash 
\endash \endash \endash \endash \endash }{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 SCHEDULE 2}{\insrsid3040484 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14179988 {\insrsid14179988 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid5315720\charrsid5654494 FEES TO BE TAKEN BY REGISTRAR}{\insrsid3040484 
\par }{\insrsid3040484\charrsid5654494 Reg 30}{\insrsid3040484 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3040484 {\insrsid3040484\charrsid5654494 
\par }\trowd \irow0\irowband0\ts35\trgaph108\trleft720\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8100\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx6480\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8820
\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8406870\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid3040484\charrsid3040484 
1. Subject to (2) for every certified copy or certificate relating to an entry in any register \cell $10.00\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid3040484\charrsid3040484 \trowd \irow0\irowband0\ts35\trgaph108\trleft720\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 
\trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth8100\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx6480\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8820\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8406870\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid3040484\charrsid3040484 2. For every \'93urgent\'94 issue of a certified copy or certificate of birth\cell $15.00\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid3040484\charrsid3040484 \trowd \irow1\irowband1\ts35\trgaph108\trleft720\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 
\trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth8100\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx6480\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8820\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8406870\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid3040484\charrsid3040484 3. For registration of a name change including the issue of a birth certificate \cell $15.00\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid3040484\charrsid3040484 \trowd \irow2\irowband2\lastrow \ts35\trgaph108\trleft720\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh
\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth8100\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 
\clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx6480\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8820\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid5315720\charrsid5654494 
\par }\pard \qc \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6429153 {\insrsid5315720\charrsid5654494 FEES TO BE TAKEN BY NIUE CONSULATE GENERAL OFFICE IN NEW ZEALAND}{\insrsid5315720 
\par }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid3040484\charrsid5654494 
\par }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9778782\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid6429153\charrsid6429153 
1. For every certified copy or certificate relating to an entry in any register \cell $25.00\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\insrsid6429153\charrsid6429153 \trowd \irow0\irowband0\ts35\trgaph108\trleft720\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth8100\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx6480\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8820
\row }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9778782\yts35 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid6429153\charrsid6429153 
2. For re-typing worn out copies of any certified copy or certificate relating to an entry in any register \cell $15.00\cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\insrsid6429153\charrsid6429153 \trowd \irow1\irowband1\lastrow \ts35\trgaph108\trleft720\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh
\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth3\trwWidth8100\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol \clvertalt\clbrdrt\brdrs\brdrw10 
\clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx6480\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx8820\row }\pard \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5654494 {\insrsid11087364\charrsid5654494 
\par }}