The Death Certificate Template – Victoria, Australia is offered in multiple formats, including PDF, Word, and Google Docs. These options are both modifiable and print-ready, tailored to suit your requirements effortlessly.
Death Certificate Victoria Template – Australia Editable | PrintableSample
1. Deceased Information 2. Relationship to Deceased 3. Applicant Information 4. Cause of Death 5. Informant Details 6. Registration Details 7. Document Request 8. Declaration 9. Signatures
PDF
WORD
Examples
Full Name: [Deceased’s Full Name]
Date of Birth: [Date of Birth]
Date of Death: [Date of Death]
Place of Death: [Place of Death]
Gender: [Male/Female/Other]
Occupation: [Occupation]
Marital Status: [Marital Status]
[Cause of Death as stated by the attending physician or coroner]
Name: [Informant’s Full Name]
Relationship to Deceased: [Relationship]
Contact Information: [Phone Number, Email Address]
Cemetery Name: [Cemetery Name]
Location: [Location of Cemetery]
Plot Number: [Plot Number]
This certificate is issued in accordance with the Births, Deaths and Marriages Registration Act 1996 (Victoria) and serves as a legal document confirming the death of the person named herein.
[Issue Date]
[Registrar’s Name]
[Registrar’s Signature]
Full Name: [Deceased’s Full Name]
Date of Birth: [Date of Birth]
Date of Death: [Date of Death]
Time of Death: [Time of Death]
[Address of the Deceased]
Father’s Name: [Father’s Name]
Mother’s Name: [Mother’s Name]
Registration Number: [Registration Number]
Registration District: [District Name]
[Cause as certified by the medical professional or coroner]
Claims of death have been certified by [Name of Certifying Authority/Physician].
Registered with the Births, Deaths and Marriages office on [Registration Date].
[Registrar’s Signature]
[Seal of Registration Authority]
[Issue Date]
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