Birth Certificate Application

Application for a Canadian birth certificate

Fill in the details

Applicant name

Date of birth

Address

Child name

Child date of birth

Place of birth

Mother name

Father name

Purpose

Date

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[Applicant Name]

[Applicant Address]

19/10/2026

To the Office of the Registrar General

Service Ontario / Vital Statistics Agency

Dear Sir or Madam,

Application for Birth Certificate

I, [Applicant Name], born on [Date of Birth], residing at [Applicant Address], hereby apply for a birth certificate for the following individual:

Name of child: [Child Name]

Date of birth: [Child Date of Birth]

Place of birth: [Place of Birth]

Mother's name: [Mother Name]

Father's name: [Father Name]

The purpose of this request is: [Purpose — personal / legal].

I enclose the required fee and supporting documentation. I would be grateful if the certificate could be issued and mailed to the address provided above.

Sincerely,

_________________ / [Applicant Name] /

[Applicant Address]

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