Recording Your Choices

Personal Profile

The following includes the information required by the Registrar-General of Births, Deaths & Marriages. Please complete fully to ensure your personal details are accurately recorded and your wishes followed.

Surname (Mr/Mrs/Ms/Miss)

Name at birth

First names

Birth date

Birth place

Ethnic group

Address

If not born in NZ, year of arrival in New Zealand

Are you descended from NZ Maori?(Yes/No/Don't know)

Profession/occuption

Full name of father

Profession/occupation of father

Full maiden name of mother

Profession/occupation of mother

Married/civil union/separated/divorced

First marriage/union details

Where married/united

Age when married/united

To whom married/united

Living spouse/partner's birth date

Second and subsequent marriages/unions to be recorded on separate page.

Children living

Sons' birth dates

Daughters' birth dates

Are you a justice of the Peace

Are you a Marriage Celebrant

Honours held

Service No.

Overseas/New Zealand service

Which war/rank

Unit or regiment

Name and address of next of kin/executor who would be expected to make the funeral arrangements.

Burial or cremation

Plot (if any) new/re-open

Ashes placement: scatter/inter

Name and address of solicitor or other person holding the will

Name of funeral director with whom the funeral arrangements shall be made

Pre-arranged/pre-paid funeral with Name and address of preferred priest/clergy/celebrant

Venue of service

Flowers/donations to