Official Journal of the European Union

Lists of country-specific entry headings received from the Member States of the European Union pursuant to Article 24(2) of Regulation (EU) 2016/1191 of the European Parliament and of the Council on promoting the free movement of citizens by simplifying the requirements for presenting certain public documents in the European Union and amending Regulation (EU) No 1024/2012

(2021/C 339/01)

ANNEX I – BIRTH

Austria

Time

Other names

Academic qualifications/professional titles

Mother/parent

Surname(s)

Other names

Academic qualifications/professional titles

Forename(s)

Father/parent

Surname(s)

Other names

Academic qualifications/professional titles

Forename(s)

Belgium

Section 1

Section 2

Declared by the parent(s)

Title of nobility

Time of birth

MOTHER’S DETAILS

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Details of parent 1

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

FATHER’S DETAILS

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

CO-MOTHER’S DETAILS

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Details of parent 2

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

ACKNOWLEDGMENT

Prenatal acknowledgement certificate number

Acknowledged by

The mother

The father

The co-mother

Date of acknowledgement

Consent

The mother

The father

The co-mother

The legal representative

The child

Date (dd/mm/yyyy) of consent

Place where the consent was given

Authority before which the consent was given

Court decision establishing the consent

Court

Date (dd/mm/yyyy) of the decision

Case number or decision reference number

Bulgaria

Birth certificate (in the case of incomplete adoption)

Civil registrar’s name [forename, family name]

Patronymic

Date of birth in words (in the case of a birth certificate only)

Time of birth in hours and minutes (for 3.2.2 only)

Personal identity number

Nationality

Mother [forename, patronymic, family name]

Personal identity number/Date of birth

Father [forename, patronymic, family name]

Personal identity number/Date of birth

Adoptive parent [forename, patronymic, family name] (for 3.2.1.1 only)

Personal identity number/Date of birth

Adoptive parent [forename, patronymic, family name] (for 3.2.1.1 only)

Personal identity number/Date of birth

ISSUED ON THE BASIS OF BIRTH CERTIFICATE [NUMBER]

date [day, month, year]

drawn up in [place, municipality, region]

Cyprus

Personal identification number

Place of origin

Father’s name

Father’s surname

Mother’s name

Mother’s maiden name

Place and date of registration

Czech Republic

Birth certificate

Place of issue

Full name of registrar

Registry office where the birth is registered

Volume

Year

Page

Serial number

Personal identification number

Father

Surname/s

Surname at birth

Forename/s

Date of birth

Place and country of birth

Personal identification number

Mother

(Surname/s

Surname at birth

Forename/s

Date of birth

Place and country of birth

Personal identification number

NOTE

Germany

Not stated

Divers

Religion

PARENT 1

Surname(s)

Name at birth

Forename(s)

Religion

PARENT 2

Surname(s)

Name at birth

Forename(s)

Religion

OTHER DETAILS FROM THE REGISTER

Denmark

Middle name(s)

Place where child was named

Date on which child was named

Name of church where child was baptised

Date of baptism

Personal identification number

Place of registration of birth

Biological or adoptive parents’ full names

Estonia

Person's name

Position

Signature

Seal or stamp.

Birth certificate, registered at the Estonian Vital Statistics Office

Personal identification code

Father/Parent

Forename(s)

Surname(s)

Personal identification code

Date (dd/mm/yyyy) of birth

Mother/Parent

Forename(s)

Surname(s)

Personal identification code

Date (dd/mm/yyyy) of birth

Authority that registered the birth

Number of birth registration

Date of registration of birth

Greece

Prefecture

Municipality

Street

Telephone

Signature

The declarant and

By order of the Mayor The Head of Municipal Register

Details of birth registration certificate (number/volume/year)

Date of declaration

Family record number (former family record number, municipal unit)

S/N of family record member (former S/N of family record member)

Date of birth in words

Time

Settlement of birth

Location of birth

Type of birth

Birth order

Social security number

Special electoral number

Birth attendants

Nationality

Date on which nationality was acquired

Date of entry in municipal register

Male register (decentralised administration, municipality, municipal unit, local or municipal community)

Number/year of male register (S/N, year)

Entry in the male register (type of entry)

INFORMATION ON PARENTS

Father

Surname(s)

Forename(s)

Nationality

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

City/town abroad

Religion

Denomination

Population register

Population register number

Tax identification number

Social security number

Social security bodies

Mother

Surname(s)

Forename(s)

Nationality

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

City/town abroad

Religion

Denomination

Population register

Population register number

Tax identification number

Social security number

Social security bodies

Father’s surname (mother only)

INFORMATION ON NAMING

Date of naming

Given name

INFORMATION ON BAPTISM

Place of baptism

Church

Religion/denomination

Date of baptism

Full name of priest

Godparents

INFORMATION ON DECLARANT

Full name

Place of domicile

Category

INFORMATION ON DOCTOR

Full name

Place of domicile

Telephone

Comments

THE CERTIFICATE WAS ISSUED (REASON FOR ISSUING)

For any type of legal purpose

Other

Spain

Civil Register in which it is entered/volume/page

Time of birth

National identity card

Details of parent A

Name

Surnames

National identity card

Name and surnames of parents

Place of birth/province/country

Date of birth

Marital status

Nationality

Address

Province and country

Details of parent B

Name

Surnames

National identity card

Name and surnames of parents

Place of birth/province/country

Date of birth

Marital status

Nationality

Address

Province and country

Parents’ marriage

Date of marriage

Place

Province and country

Civil Register in which it is entered/volume/page

Finland

Visitor address

Postal address

Place and postal code

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

Previous surnames (after the age of 15)

Forename normally used

Municipality of residence at birth

Abroad

Unknown

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Municipality of residence

No municipality of residence in Finland

Abroad

Unknown

PERSON’S PARENTS

Father

Surname(s)

Previous surnames

Forename(s)

Forename normally used

Date (dd/mm/yyyy) of birth

Place and country of birth

Municipality of residence at birth

Abroad

Unknown

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Mother

Surname(s)

Previous surnames

Forename(s)

Forename normally used

Date (dd/mm/yyyy) of birth

Place and country of birth

Municipality of residence at birth

Abroad

Unknown

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

France

Time (hh:mm) when the birth certificate was issued

Surname(s) of the local registrar who issued the birth certificate

First name(s) of the local registrar who issued the birth certificate

Father’s (mother’s) surname(s)

Father’s (mother’s) first name(s)

Date (dd/mm/yyyy) of father’s (mother’s) birth

Place and country of father’s (mother’s) birth

Father’s (mother’s) occupation

Father’s (mother’s) domicile

Mother’s (father’s) surname(s)

Mother’s (father’s) first name(s)

Date (dd/mm/yyyy) of mother’s (father’s) birth

Place and country of mother’s (father’s) birth

Mother’s (father’s) occupation

Mother’s (father’s) domicile

Time (hh:mm) of birth

Parent making declaration: Father and/or mother

Third party making declaration

Surname of declarant

First name(s) of declarant

Age of declarant

Occupation of declarant

Domicile of declarant

Date of the decision (or order) and name of the authority

Nature of the decision

Date and name of the authority which issued the decision for entry in the register

Main information: marriage (date (dd/mm/yyyy) and place of marriage, surname(s) and first name(s) of spouse), divorce (surname(s) and first name(s) of former spouse, date (dd/mm/yyyy), nature of the decision or certificate and name of the authority), legal separation (surname(s) and first name(s) of the other spouse, date (dd/mm/yyyy), nature of the decision and the court which ruled on the separation), dissolution of the marriage by annulment (date (dd/mm/yyyy), nature of the decision and the court which annulled the marriage), conclusion/modification/dissolution of a civil partnership (type of registration - conclusion, modification or dissolution of the civil partnership -, date (dd/mm/yyyy) and place of registration, partner’s surname(s)/first name(s)/date (dd/mm/yyyy), place and country of birth), death (date (dd/mm/yyyy) and place of death), nationality (date (dd/mm/yyyy), type of decision and designation of the authority which decided to grant/take away/reinstate French nationality, entry in the civil repository (evidence of entry in the civil repository (RC) and registration number)

Other information

Croatia

Surname and forename of the official who issued the certificate

Function of the official who issued the certificate

Place of issue

Registration district

District in which the birth was registered

Year of registration

Serial number under which the birth was registered

Date of registration

OIB (Personal Identification Number)

Time of birth

Ethnicity

Nationality

Information on the father

Forename(s)

Surname(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Information on the mother

Forename(s)

Surname(s)

Surname(s) before the marriage

Date (dd/mm/yyyy) of birth

Place and country of birth

Notes

Place of issue

Hungary

Place of issue

Series

Name of the official who issued the extract from the civil status register

Position of the official who issued the extract from the civil status register

Unique civil status register electronic identifier

Father’s surname(s) and forename(s) at birth

Mother’s surname(s) and forename(s) at birth

Place of origin

Notes

Ireland

Registered in the Registrar's Office

Registrar

Superintendent Registrar's Registration Area

County

Date of Registration or Re-registration (if applicable)

Issued in Pursuance of the Civil Registration Act 2004

Certified to be compiled from a register maintained under section 13 of the Civil Registration Act 2004

Certified to be a true copy of the register maintained under section 13 of the Civil Registration Act 2004

To alter this certificate or to use it as altered is a serious offence

Issued by

Time of Birth

Multiple Birth

Mother/parent

Surname(s)

Forename(s)

Birth Surname

Former Surnames

Parents' Mother's Birth Surname

Civil Status

Occupation

Address

Date (dd/mm/yyyy) of birth

Father/parent

Surname(s)

Forename(s)

Birth Surname

Former Surnames

Parents' Mother's Birth Surname

Civil Status

Occupation

Address

Date (dd/mm/yyyy) of birth

Informant A

Qualification

Signed by

Surname(s)

Forename(s)

Address

Informant B

Qualification

Signed by

Surname(s)

Forename(s)

Address

Italy

Certificate of record of birth from civil status registers

Certificate of birth based on entry in population register

Extract of record of birth from civil status registers

Place of issue

First name and surname of official who drew up the record

Volume, part, series

Year

Number

Time of birth

First name and surname of mother

First name and surname of father

Annotations to birth certificate

Lithuania

Extract confirming the record of birth

The extract confirming the record of birth is correct

Job title

Signature

Forename and surname of official

Stamp

Personal identification number

Ethnicity

Citizenship

Information about the mother

Personal identification number

Forename(s)

Surname(s)

Date (dd/mm/yyyy) of birth

Ethnicity

Citizenship

Information about the father

Personal identification number

Forename(s)

Surname(s)

Date (dd/mm/yyyy) of birth

Ethnicity

Citizenship

Comments

RECORD OF BIRTH

Name of civil registry or consular office

Date (dd/mm/yyyy)

Number

Place of completion

Code of civil registry or consular office

Luxembourg

Signature and seal of depository

Place and country of issue

Parent A

Surname(s)

Forename(s)

Sex

Female

Male

Date (dd/mm/yyyy) of birth

Place and country of birth

Parent B

Surname(s)

Forename(s)

Sex

Female

Male

Date (dd/mm/yyyy) of birth

Place and country of birth

Latvia

Personal identification number

Time of birth (a.m./p.m.)

Ethnicity

Country of citizenship

INFORMATION ON FATHER

Surname(s)

Forename(s)

Personal identification number

Ethnicity

Country of citizenship

INFORMATION ON MOTHER

Surname(s)

Forename(s)

Personal identification number

Ethnicity

Country of citizenship

INFORMATION ON REGISTER OF BIRTHS

Registering authority

Date of registration

Entry number in register

Malta

Public Registry

Signature of the Director of the Public Registry or other Office authorised to act in his/her stead

Date of Act

Progressive Number of the entry / inscription

Names Given

Hour, day, month and year

Father

Surname(s)

Forename(s)

Identification Document

Age - Years

Profession, trade or other status

Place and country of birth

Residence

Name and surname of the father, and whether living or dead (grandfather of the child)

Name and surname of the parents, including surname at birth, and whether living or dead

the parent

Surname(s)

Forename(s)

Mother

Surname(s)

Forename(s)

Place and country of birth

the parent who gave birth to the child

Surname(s)

Forename(s)

Identification Document

Age - Years

Profession, trade or other status

Residence

Name and surname of the father, and whether living or dead (grandfather of the child)

Name and surname of the parents, including surname at birth, and whether living or dead

The Person making the declaration

Annotations/ Addenda

Netherlands

Extract from certificate of stillbirth

Extract from birth certificate (stillborn)

This extract contains information relating to the original

Certificate of stillbirth

Birth certificate (stillborn)

This copy is made up of … page(s) and corresponds to the original

Place of issue

Name of registrar

Signature

Hour and minute of birth

Parents

Father’s surname

Mother’s surname

Father’s forenames

Mother’s forenames

Surname of the mother giving birth to the child

Forenames of the mother giving birth to the child

Other information

Chosen surname

Parents’ birth details

Father’s place of birth

Mother’s place of birth

Father’s date of birth

Mother’s date of birth

Place of birth of the mother giving birth to the child

Date of birth of the mother giving birth to the child

Declarant

Surname(s)

Forename(s)

Place and country of birth

Date (dd/mm/yyyy) of birth

ADMINISTRATIVE DETAILS AND SIGNATURES

Place and date of act

Name of registrar

Signature

AMENDMENTS AND SUBSEQUENT ENTRIES

Certificate within the meaning of Article 1:19i(1) of the Civil Code

Other entries

Later entries regarding recognition

Continuation sheet

Ref.

Document

Reference number of the public document

Done at

On

By

Person recognising the child

Father’s surname

Father’s forenames

Place and country of birth

Date (dd/mm/yyyy) of birth

Authorised by

Child’s surname

Chosen surname

Recognition under the law of

Administrative details and signatures

Place and date of act

Name of registrar

Signature

Later entries regarding recognition

Continuation sheet

Ref.

Document

Reference number of the public document

Done at

On

By

Person recognising the child

Mother’s surname

Mother’s forenames

Place and country of birth

Date (dd/mm/yyyy) of birth

Authorised by

Child’s surname

Chosen surname

Recognition under the law of

Administrative details and signatures

Place and date of act

Name of registrar

Signature

Later entries regarding choice of name

Continuation sheet

Ref.

Document

Reference number of the public document

Done at

On

By

Chosen surname

Administrative details and signatures

Place and date of act

Name of registrar

Signature

Poland

The copy is consistent with the wording of birth certificate No

Forename, surname and position of the person who issued the document

Place where the document was drawn up

Stamp duty

not subject

exempt

collected

Parents’ details

Mother

Forename(s)

Surname at birth

Father

Forename(s)

Surname at birth

Portugal

Time of birth

Child of A

Name

Age

Civil status

Married

Unmarried

Divorced

Widowed

Other (to be specified)

Place of birth

Habitual residence

Child of B

Name

Age

Civil status

Place of birth

Habitual residence

Special remarks

The parents are foreign nationals

Comments on the birth certificate

Married … (name of spouse) on … (date)

Death of spouse on … (date)

Divorced on … (date)

Non-existence of the marriage on … (date)

Annulment of the marriage on … (date)

Marriage declared null and void on … (date)

Legal separation on … (date)

Reconciliation of spouses on … (date)

Conversion of legal separation into divorce on … (date)

Parental responsibility established on … (date) with custody granted to … (names(s)) who exercise(s) parental responsibility.

Guardianship established on … (date) and … (name) appointed as guardian.

Declared legally incapacitated on … (date) and … (name) appointed as conservator.

Declared legally incompetent on … (date) and … (name) appointed as guardian.

Parental responsibility exercised by … (name).

Name changed to … (new name) on … (date).

Died on … (date)

Body found on … (date).

Declaration of presumed death issued on … (date).

Portuguese nationality granted on … (date).

Acquired Portuguese nationality on … (date).

Portuguese nationality withdrawn on … (date).

Romania

Birth certificate No / dated (dd/mm/yyyy)

Registered at (Locality/Embassy/Consulate/County)

Personal Identification Number

Parents’ details

Father’s surname

Father’s first name

Mother’s surname

Mother's first name

REMARKS

Yes

No

Sweden

Mother

Date (dd/mm/yyyy) of birth

Citizenship

Surname(s)

Forename(s)

Place and country of birth

National identification No

Father

Date (dd/mm/yyyy) of birth

Citizenship

Surname(s)

Forename(s)

Place and country of birth

National identification No

Slovenia

Serial number of the document

Personal Identification Number

Surname of father

Forename of father

Surname of mother

Forename of mother

Nationality

Notes

Slovakia

Birth certificate

Register of births

Place of issue

Full name of registrar

Signature

Volume

Year

Page

Serial number

Personal Identification Number

Father

Forename(s)

Surname(s)

Surname at birth

Date (dd/mm/yyyy) of birth

Place and country of birth

Nationality

Personal Identification Number

Mother

Forename(s)

Surname(s)

Surname at birth

Date (dd/mm/yyyy) of birth

Place and country of birth

Nationality

Personal Identification Number

Notes

ANNEX II – LIFE

Belgium

This document is issued

following the person’s appearance in court

on the basis of the Population Register

on the basis of the ID card

Title of nobility

Pseudonym

National registration number

Nationality

Civil status

Married

Unmarried

Divorced

Widowed

Date (dd/mm/yyyy) of marriage

Date (dd/mm/yyyy) of divorce

Date (dd/mm/yyyy) of death

Surname(s) of former spouse

First name(s) of former spouse

Germany

Not stated

Divers

Estonia

Person's name

Position

Signature

Seal or stamp

Personal identification code

Date of commencement of residence at place of residence

Civil status

Married/Date (dd/mm/yyyy) of marriage

Never married

Divorced/Date (dd/mm/yyyy) of divorce

Widowed/ Date (dd/mm/yyyy) of spouse’s death

Undetermined

Nationality

Estonia

Undetermined

Other (specify)

Additional address

Street and number/PO box

Place and postal code

Country

Date additional address became effective

Person’s status

Living

Deceased

No data

Undetermined

Names

Surname(s)

Forename(s)

Date name changed

Document type

Spain

Civil Register

Name and surnames of parent A

Name and surnames of parent B

Finland

Visitor address

Postal address

City

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Previous surnames

Previous surnames (after the age of 15)

Previous forenames

Previous forenames (people over 15 years old)

Forename normally used

Municipality of residence at birth

Abroad

Unknown

Date of move (dd/mm/yyyy)

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Civil status

Single

Married

Divorced

Widow/widower

Registered partner

Divorced from registered partnership

Widowed from registered partnership

Unknown

Mother tongue

France

Presentation of an identity document

The person appeared before this authority

Hungary

Place of issue

Mother’s name

Nationality

Means of identification

Identification document number

Luxembourg

Data extracted from the National Register of Natural Persons in accordance with Article 4 of the Grand-Ducal Regulation of 29 March 2016 concerning certain certificates issued on the basis of the data contained in the National Register of Natural Persons (Mémorial [Luxembourg Official Gazette] A No 52 of 31 March 2016). These data are certified correct unless indicated by an asterisk on a light grey background (*).

Place and country of issue

Identification number

Latvia

Time of issue

Personal identification number

Identity established on basis of passport

Identity established on basis of identity card

Number of identification document

Date of issue of identification document

Document issued by (authority)

COSTS

Remuneration (please specify)

VAT

State charge collected

Other (specify)

Total

Netherlands

Place of issue

Name of registrar

Signature

Check carried out

National identity card

Passport

Driving licence

Residence permit

Municipal registers

Consular registers

Other proof(s) of identity

Poland

Notary fees

collected

benefits from exemption

Father’s forename

Mother’s forename

Identity document

ID card

passport

other document (please specify)

Issue No and reference No

Romania

Personal Identification Number

Document of identity [e.g., Identity card, temporary ID, Passport, if applicable]

Type of document

Series and number

Issued by [relevant authority]

Date of issuance

Reference number of the annex

Sweden

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

ANNEX III – DEATH

Austria

Date

Other names

Academic qualifications/professional titles

Last place of residence

Place of birth

Court of issue, date and number of declaration of death

Last marriage/registered partnership

Civil status data of survivor (spouse/registered partner)

Surname(s)

Other names

Academic qualifications/professional titles

Forename(s)

Sex

Female

Male

Belgium

Title of nobility

Time of death

Place and country of birth

Place of discovery of the dead body

Date of discovery of the dead body

Time of discovery of the dead body

Bulgaria

Civil registrar’s name [forename, family name]

Patronymic

Time of death in hours and minutes

Personal identity number

Place of Birth

Nationality

Family status

Permanent address

Issued on the basis of death certificate [number]

date [day, month, year]

drawn up in [place, municipality, region]

Cyprus

Personal identification number

Father’s name

Father’s surname

Place and date of registration

Czech Republic

Death certificate

Place of issue

Full name of registrar

Registry office where the death is registered

Volume

Year

Page

Serial number

Surname at birth

Place and country of birth

Personal status

Personal identification number

Place and country of permanent residence

Husband/Wife, Partner

Surname(s)

Forename(s)

Surname at birth

Personal identification number

Note

Germany

Time of death

Not stated

Divers

Name at birth

Religion

Marital status

HUSBAND/ WIFE/ SPOUSE/ REGISTERED PARTNER (OF THE DECEASED PERSON WHOSE DEATH IS BEING REGISTERED)

Surname(s)

Name at birth

Forename(s)

Other details from the register

Denmark

Middle name(s)

Place of registration of death

Place of burial

Place of registration of birth

Personal identification number

Surviving or predeceased spouse’s full name

Spouse’s personal identification number or date of birth

Estonia

Person's name

Position

Signature

Seal or stamp.

Death Certificate, Registered At The Estonian Vital Statistics Office

Personal identification code

Authority that registered the death

Death registration number

Date of registration of death

Greece

Prefecture

Municipality

Street

Telephone

Details of death registration certificate (number/volume/year)

Date of declaration

Place of birth (municipality, prefecture, country)

Settlement of birth

Father’s forename

Mother's forename

Nationality

Religion

Age

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

Municipality of registration

Population register number

Marital status

Profession

Type of identity card

Identity card number

Date of issue of identity card

Tax identification number

Social security number

Pension providers

INFORMATION ON DECLARANT

Full name

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

INFORMATION ON BURIAL/CREMATION

Place

Date of burial

Time

INFORMATION ON THE DEATH

Place

Time

Cause

INFORMATION ON SPOUSE

Surname(s)

Forename(s)

The declarant and

Spain

Civil Register in which it is entered/volume/page

Time of death

Place of birth/province/country

Civil Register in which birth is entered/volume/page

National identity card

Name and surnames of parent A

Name and surnames of parent B

Marital status

Nationality

Last address/province/country

Place of burial/province/country

Finland

Visitor address

Postal address

City

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Previous surnames

Previous surnames (after the age of 15)

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Municipality of residence at birth

Abroad

Unknown

Personal identity number

Main place of residence

Address of residence

Place and postal code

Date of move (dd/mm/yyyy)

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Citizenship

Stateless

Not yet determined

Unknown

Civil status

Single

Married

Separated

Divorced

Widow/widower

Registered partner

Divorced from registered partnership

Widowed from registered partnership

No data

Mother tongue

France

Time (hh:mm) when the death certificate was issued

Surname(s) of the local registrar who issued the death certificate

First name(s) of the local registrar who issued the death certificate

Time (hh:mm) of death

Place and country of birth of the deceased person

Occupation of the deceased person

Domicile of the deceased person

Father’s (mother’s) surname(s)

Father’s (mother’s) first name(s)

Father’s (mother’s) occupation

Father’s (mother’s) domicile

Mother’s (father’s) surname(s)

Mother’s (father’s) first name(s)

Mother’s (father’s) occupation

Mother’s (father’s) domicile

Surname(s) of adoptive parent

First name(s) of adoptive parent

Surname(s) of the other spouse (if the deceased person was married, widowed or divorced)

First name(s) of the other spouse (if the deceased person was married, widowed or divorced)

Surname(s) of the other partner (if the deceased person was in a civil partnership)

First name(s) of the other partner (if the deceased person was in a civil partnership)

Surname(s) of declarant

First name(s) of declarant

Age of declarant

Occupation of declarant

Domicile of declarant

Relationship with the deceased person

Date of the decision and name of the authority

Date and name of the authority which issued the decision for entry in the register

Other information

Croatia

Surname and forename of the official who issued the certificate

Function of the official who issued the certificate

Place of issue

OIB (Personal Identification Number)

Time of death

Place of birth

Registration district

District in which the death was registered

Year of registration

Serial number under which the death was registered

Date of registration

Ethnicity

Nationality

First name and surname of spouse and surname prior to marriage

Information on the father

Forename(s)

Surname(s)

Information on the mother

Forename(s)

Surname(s)

Notes

Code number

Place of issue

Hungary

Place of issue

Series

Name of the official who issued the extract from the civil status register

Position of the official who issued the extract from the civil status register

Unique civil status register electronic identifier

Married name

Surname(s) and forename(s) at birth

Marital status

Place of birth

Age

Father’s surname(s) and forename(s) at birth

Mother’s surname(s) and forename(s) at birth

Surname(s) and forename(s) at birth of spouse or registered partner

Notes

Ireland

Death Registered on foot of a Coroner's Certificate

Coroner's Office

Date of Post Mortem

Date of Inquest.

Forename(s)

Surname(s)

Qualification

Registered in the Registrar's Office

Superintendent Registrar's Registration Area

County

Date of Registration

Registration Number

Registrar

Issued in Pursuance of the Civil Registration Act 2004

Certified to be compiled from a register maintained under section 13 of the Civil Registration Act 2004

Certified to be a true copy of the register maintained under section 13 of the Civil Registration Act 2004

To alter this certificate or to use it as altered is a serious offence

Issued by

Birth Surname

Age

Place of Birth

Civil Status

Former Residence

Rank, Profession or Occupation

Certified Cause of Death and Duration of Illness

Occupation of Spouse

Father/parent

Forename(s)

Surname(s)

Occupation of Parent/Guardian 1

Mother's/Parent's Birth Surname

Mother/parent

Forename(s)

Surname(s)

Occupation of Parent/Guardian 2

Informant

Qualification

Address

Surname(s)

Forename(s)

Medical Practitioner Details

Surname(s)

Forename(s)

Qualification

Address

Telephone

Italy

Certificate of record of death from civil status registers

Certificate of death based on entry in population register

Extract of record of death from civil status registers

Place of issue

First name and surname of official who drew up the record

Volume, part, series

Year

Number

Time of death

Place of birth

Number, part, series, year, volume of birth certificate

Civil status of the deceased

Married - in a civil partnership

Widow/Widower

Divorced

Single

Annotations to birth certificate

Place of issue

Lithuania

Extract confirming the record of death

The extract confirming the record of death is correct

Job title

Signature

Forename and surname of official

Stamp

Personal identification number

Citizenship

Cause of death

Comments

Record of death

Name of civil registry or consular office

Date (dd/mm/yyyy)

Number

Place of completion

Code of civil registry or consular office

Luxembourg

Signature and seal of depository

Place and country of issue

Place and country of birth

Last spouse

Surname(s)

Forename(s)

Sex

Female

Male

Parent A

Surname(s)

Forename(s)

Sex

Female

Male

Parent B

Surname(s)

Forename(s)

Sex

Female

Male

Latvia

Personal identification number

Time of death (a.m./p.m.)

Place of birth

DOCUMENT ATTESTING TO INFORMATION

Death certificate

Other (specify)

Document number

Date of issue of document

Document issued by (authority)

INFORMATION ON REGISTER OF DEATHS

Registering authority

Date of registration

Entry number in register

Malta

Public Registry

Signature of the Director or other Officer authorised to act in his stead

Officer in charge

Date of the Act

Date of receipt of the Act

Progressive number of the Inscription

Place of birth

Whether married or unmarried, widower or widow

Identification Document

Age, Years

Profession, Trade or Status

Place of Residence

Name and Surname of parents, whether living or dead

Cause of death

Time of death

Place of burial

Annotations / Addenda

Netherlands

This extract contains information relating to the original

Death certificate (discovery of corpse)

This copy is made up of … page(s) and tallies with the original

Place of issue

Name of registrar

Signature

Place of residence

Hour and minute of death

Date on which the body was found

Hour and minute body was found

Place where the body was found

Place of birth

Married to

Registered partner of

Parents of the deceased

Father’s surname

Father’s forenames

Mother’s surname

Mother’s forenames

Other information

Married to/registered partner of

Declarant

Surname

Forenames

Place of birth

Date (dd/mm/yyyy) of birth

Administrative details and signatures

Place and date of act

Name of registrar

Signature

Amendments and subsequent entries

Other entries

Poland

The copy is consistent with the wording of death certificate No

Forename, surname and position of the person who issued the document

Place where the document was drawn up

Stamp duty

not subject

exempt

collected

Surname at birth

Civil status

Never married

Divorced

Widowed

Married

Place of birth

Details of deceased person’s spouse

Forename(s)

Surname(s)

Surname at birth

Details of deceased person’s parents

Mother

Forename(s)

Surname at birth

Father

Forename(s)

Surname at birth

Details of death

Time of death (hh/mm)

Date of discovery of body (dd/mm/yyyy)

Time body discovered (hh/mm)

Place body discovered

Portugal

Time of death

Place of burial

Civil status

Married

Unmarried

Divorced

Widowed

Other (to be specified)

Place of birth

Last habitual residence

Child of A

Child of B

Romania

Death certificate No / dated (dd/mm/yyyy)

Registered at (Locality/Embassy/Consulate/County)

Place of birth

Domicile (Locality, street and number, County)

Personal Identification Number

Parents’ details

Father’s surname

Father’s first name

Mother’s surname

Mother's first name

Remarks

Yes

No

Sweden

National identification No

Registration in national population register

Date

County

Municipality

Slovenia

Serial number of the document

Personal Identification Number

Place of Birth

Last permanent residence

Surname of spouse

Forename of spouse

Personal Identification Number of spouse

Notes

Slovakia

Death certificate

Register of deaths

Place of issue

Full name of registrar

signature

volume

year

page

Serial number

Surname at birth

Place of birth

Notes

ANNEX IV – MARRIAGE

Austria

Time

Other names

Academic qualifications/professional titles

Place of birth

Other names

Academic qualifications/professional titles

Place of birth

Belgium

Title of nobility

Place and country of birth

Title of nobility

Place and country of birth

WITNESSES

Witness 1

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Witness 2

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Witness 3

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Witness 4

Surname(s)

Title of nobility

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

OTHER HEADINGS

Divorce

Court

Date (dd/mm/yyyy) of the court decision

Date (dd/mm/yyyy) when the court decision became res judicata

Date (dd/mm/yyyy) of entry in the civil status register/Date (dd/mm/yyyy) of registration in the Belgian database of civil status records

Case number or decision reference number

Marriage annulment

Court

Date (dd/mm/yyyy) of the court decision

Case number or decision reference number

Bulgaria

Civil registrar’s name [forename, family name]

Patronymic

Personal identity number

Place of birth (for 3.2.2 only)

Marital status before marriage (for 3.2.2 only)

Patronymic

Personal identity number

Place of birth (for 3.2.2 only)

Marital status before marriage (for 3.2.2 only)

Other information

Matrimonial property regime (for 3.2.2 only)

Field for comments (for 3.2.2 only)

ISSUED ON THE BASIS OF CIVIL MARRIAGE CERTIFICATE [NUMBER]

date [day, month, year]

drawn up in [place, municipality, region]

Cyprus

Marital status

Citizenship

Permanent residence

Parent’s name and surname

Marital status

Citizenship

Permanent residence

Parent’s name and surname

Spouse A

Surname(s) at birth

Forename(s)

ID card/passport number

Signature

Spouse B

Surname(s) at birth

Forename(s)

ID card/passport number

Signature

Surname and name of Witness 1

ID card/passport number of Witness 1

Signature

Surname and name of Witness 2

ID card/passport number of Witness 2

Signature

Czech Republic

Marriage certificate

Place of issue

Full name of registrar

Registry office where the marriage is registered

Volume

Year

Page

Serial number

Place and country of birth

Personal identification number

Personal status

Forename, surname and surname at birth of the father

Forename, surname and surname at birth of the mother

Place and country of birth

Personal identification number

Personal status

Forename/s, surname and surname at birth of the father

Forename, surname and surname at birth of the mother

AGREED SURNAME OF THE CHILDREN OF BOTH SPOUSES

NOTE

Germany

Surname(s) after the dissolution of the marriage

Forename(s) at birth

Forename(s) before the marriage

Forename(s) during the marriage

Forename(s) after the dissolution of the marriage

Place of birth

Not stated

Divers

Husband

Wife

Spouse

Religion

Other details from the register

Notices

Birth Spouse A

Registry office

Register number

Surname(s) after the dissolution of the marriage

Forename(s) at birth

Forename(s) before the marriage

Forename(s) during the marriage

Forename(s) after the dissolution of the marriage

Forename(s) following the marriage

Place of birth

Not stated

Divers

Husband

Wife

Spouse

Religion

Other details from the register

Notices

Birth Spouse B

Registry office

Register number

Denmark

Address

Middle name(s)

Personal identification number

Place of registration of birth

Middle name(s)

Personal identification number

Place of registration of birth

Estonia

Person's name

Position

Signature

Seal or stamp.

Marriage certificate, registered at an Estonian vital statistics office

Authority that registered the marriage

Other data

No other data

Marriage terminated

Source document

Personal identification code

Personal identification code

Greece

Prefecture

Municipality

Street

Telephone

Details of marriage registration act (number/volume/year)

Date of declaration

Declarant (husband or wife)

Time

Type

Denomination

Municipality

Municipal/local community

Surname of children

Male

Country of birth

City/town of birth (abroad)

Municipality of birth

Municipal/local community of birth

Father’s forename

Mother’s forename

Father’s surname

Mother’s surname

Nationality

Religion

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

Population register

Population register number

Tax identification number

Social security number

Social security bodies

Degree of marriage

Female

Country of birth

City/town of birth (abroad)

Municipality of birth

Municipal/local community of birth

Father’s forename

Mother’s forename

Father’s surname

Mother’s surname

Nationality

Religion

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

Population register

Tax identification number

Population register number

Social security number

Social security bodies

Degree of marriage

INFORMATION ON DECLARANT

Forename

Surname

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

The declarant and

COMMENTS

Spain

Civil Register in which it is entered/volume/page

Time of celebration of marriage

Place of birth/province/country

Name and surnames of parent A

Name and surnames of parent B

Civil Register in which birth is entered/volume/page

Marital status

Address/province/country

Nationality

National identity card

Place of birth/province/country

Name and surnames of parent A

Name and surnames of parent B

Civil Register in which birth is entered/volume/page

Marital status

Address/province/country

Nationality

National identity card

Finland

Visitor address

Postal address

Place and postal code

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Previous surnames

Previous surnames (after the age of 15)

Current surname

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Municipality of residence at birth

Abroad

Unknown

Country of birth

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Civil status

Single

Married

Separated

Divorced

Widow/widower

Registered partner

Divorced from registered partnership

Widowed from registered partnership

No data

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Marriage number

Main place of residence

Date of move (dd/mm/yyyy)

Previous surnames

Previous surnames (after the age of 15)

Current surname

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Municipality of residence at birth

Abroad

Unknown

Country of birth

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Marriage number

Main place of residence

Date of move (dd/mm/yyyy)

France

Surname(s) of the local registrar who issued the marriage certificate

First name(s) of the local registrar who issued the marriage certificate

Time (hh:mm) when the marriage certificate was issued

Place and country of birth

Occupation

Domicile

Residence

Father’s surname(s)

Father’s first name(s)

Father’s occupation

Father’s domicile

Mother’s surname(s)

Mother’s first name(s)

Mother’s occupation

Mother’s domicile

Surname(s) of adoptive parent

First name(s) of adoptive parent

Father’s and/or mother’s consent (if required)

Consent of grandfather(s) and/or grandmother(s) (if required)

Consent of the family council (if required)

Surname(s) of former spouse

First name(s) of former spouse

Place and country of birth

Occupation

Domicile

Residence

Father’s surname(s)

Father’s first name(s)

Father’s occupation

Father’s domicile

Mother’s surname(s)

Mother’s first name(s)

Mother’s occupation

Mother’s domicile

Surname(s) of adoptive parent

First name(s) of adoptive parent

Father’s and/or mother’s consent (if required)

Consent of grandfather(s) and/or grandmother(s) (if required)

Consent of the family council (if required)

Surname(s) of former spouse

First name(s) of former spouse

Declaration of intent to marry and pronouncement of marriage

Surname(s) of first witness

First name(s) of first witness

Occupation of first witness

Domicile of first witness

Surname(s) of second witness

First name(s) of second witness

Occupation of second witness

Domicile of second witness

Surname(s) of third witness (if applicable)

First name(s) of third witness (if applicable)

Occupation of third witness (if applicable)

Domicile of third witness (if applicable)

Surname(s) of fourth witness (if applicable)

First name(s) of fourth witness (if applicable)

Occupation of fourth witness (if applicable)

Domicile of fourth witness (if applicable)

Date (dd/mm/yyyy) of the marriage contract, surname(s) and place of residence of the notary who received the marriage contract (if applicable)

Act designating the law applicable to the matrimonial property regime, in accordance with the Hague Convention of 14 March 1978 on the Law Applicable to Matrimonial Property Regimes, date (dd/mm/yyyy) and place where the act was signed, name and position of the person who issued the act (if applicable)

Main information: divorce (surname(s) and first name(s) of the former spouse, date (dd/mm/yyyy), nature of the decision or certificate and name of the authority), legal separation (surname(s) and first name(s) of the other spouse, date (dd/mm/yyyy), nature of the decision and the court which ruled on the separation), dissolution of the marriage by annulment (date (dd/mm/yyyy), nature of the decision and the court which annulled the marriage), change of matrimonial property regime (date (dd/mm/yyyy) of the notarial act or decision, name and position of the person who issued the act or nature of the decision and the court which ruled on the change of matrimonial property regime)

Other information

Croatia

Surname and forename of the official who issued the certificate

Function of the official who issued the certificate

Place of issue

Registration district

District in which the marriage was registered

Year of registration

Serial number under which the marriage was registered

OIB (Personal Identification Number) of groom

Place of birth of groom

Ethnicity of groom

Nationality of groom

OIB (Personal Identification Number) of bride

Place of birth of bride

Ethnicity of bride

Nationality of bride

Notes

Code number

Place of issue

Hungary

Place of issue

Series

Name of the official who issued the extract from the civil status register

Position of the official who issued the extract from the civil status register

Unique civil status register electronic identifier

Forename(s) at birth

Place of birth

Unique civil status register electronic identifier

Forename(s) at birth

Place of birth

Notes

Ireland

Registered in the Registrar's Office

Superintendent Registrar's Registration Area

County

Date of Registration

Issued in Pursuance of the Civil Registration Act 2004

Certified to be compiled from a register maintained under section 13 of the Civil Registration Act 2004

To alter this certificate or to use it as altered is a serious offence

Issued by

Marriage Solemnised at

According to

Signed by

Party 1

Party 2

Witness 1

Witness 2

Solemniser

Other Surnames

Age

Address

Future Address

Occupation

Civil Status

Mother's Forename & Birth Surname

Father's Forename & Birth Surname

Other Surnames

Age

Address

Future Address

Normal Residence before Marriage

Occupation

Civil Status

Mother's Forename & Birth Surname

Father's Forename & Birth Surname

Italy

Certificate of record of marriage from civil status registers

Certificate of marriage based on entry in population register

Extract of record of marriage from civil status registers

Place of issue

First name and surname of official who drew up the record

Time of marriage

Place of birth

Details on birth certificate

Residence

Nationality

Annotations

Place of birth

Details on birth certificate

Residence

Nationality

Annotations

Place of issue

Lithuania

Job title

Signature

Forename and surname of official

Stamp

Extract confirming the record of marriage

The extract confirming the record of marriage is correct

Comments

INFORMATION CONCERNING THE SPOUSES

HE

Place of birth

Personal identification number

Citizenship

SHE

Personal identification number

Place of birth

Citizenship

RECORD OF MARRIAGE

Name of civil registry or consular office

Date (dd/mm/yyyy)

Number

Place of completion

Code of civil registry or consular office

Luxembourg

Signature and seal of depository

Place and country of issue

Place and country of birth

Place and country of birth

DISSOLUTION OF THE MARRIAGE

Reason for the dissolution

Divorce

Annulment

Legal separation

Date of the court decision

Judgment of dd/mm/yyyy

Appeal judgment of dd/mm/yyyy

Latvia

Personal identification number

Place of birth

Country of citizenship

Personal identification number

Place of birth

Country of citizenship

INFORMATION ON REGISTER OF MARRIAGES

Registration authority

Date of registration

Entry number in register

Malta

Date of the Act

Curia No.

MR No.

Declaration of the husband and wife

Declaration of the spouses

We the undersigned hereby declare that we have in the presence of (…)

and of the undermentioned witnesses contracted marriage at (…)

The above declarations were signed in my presence.

Parish

Declaration of officiating minister

I, the undersigned, Officiating Minister / Parish Priest / Delegate, hereby declare that the undermentioned and undersigned spouses, in the presence of the witnesses also undermentioned and undersigned, were by me requested to give, and gave, their consent and were united in marriage according to the laws and rites of the Catholic Church

We the undersigned hereby declare that we have in the presence of (parish priest / officiating minister) and of the witnesses above mentioned contracted marriage at (Church) on (Date)

I the undersigned (the wife) declare that I choose to: adopt the surname of my husband/ retain my maiden surname after marriage/adopt the surname of my predeceased spouse. (delete where not applicable).

We the undersigned hereby declare that we choose to adopt for both of us the surname of one of the parties to the marriage/adopt for both of us the surnames of the two parties in the marriage in this order/to retain our current surname after marriage. (delete where not applicable)We the undersigned hereby declare that we choose - as our Family Name that shall be the surname of any future children.

We the undersigned hereby declare that we choose … as our Family Name that shall be the surname of any future children

After I read out this Act to the spouses and the witnesses, they signed

Husband’s Signature

Signature of the spouse

Wife’s Signature

Signature of the spouse

Witnesses’ Signatures

Signature of Marriage Registrar

Signature of Officiating Minister

Date of the receipt of the Act.

Progressive number of Registration No.

Signature of Director or other officer authorized to act in his stead.

Parish Seal

Annotations / Addenda

Particulars of the witnesses

Witness 1

Name and Surname

Date and Place of Birth

Place of Residence

Witness 2

Name and Surname

Date and Place of Birth

Place of Residence

Witness 3

Name and Surname

Date and Place of Birth

Place of Residence

Witness 4

Name and Surname

Date and Place of Birth

Place of Residence

Place of birth

Identification document

Place of Residence

Name and Surname of Father, and Name, Surname and Maiden Surname of Mother

Name and surname of parents including surnames at birth

Place of birth

Identification document

Place of Residence

Name and Surname of Father, and Name, Surname and Maiden Surname of Mother

Name and surname of parents including surnames at birth

Netherlands

This extract contains information relating to the original

Place of issue

Name of registrar

Signature

Place of birth

Place of birth

OTHER ENTRIES

Date and place of divorce

Date and place of dissolution

Date and place of annulment

Date and place of conversion

Poland

The copy is consistent with the wording of marriage certificate No

Forename, surname and position of the person who issued the document

Place where the document was drawn up

Stamp duty

not subject

exempt

collected

Surnames of any children from this marriage

Place of birth

Parents’ details

Mother

Forename(s)

Surname at birth

Father

Forename(s)

Surname at birth

Current surname if different from married name

Place of birth

Parents’ details

Mother

Forename(s)

Surname at birth

Father

Forename(s)

Surname at birth

Current surname if different from married name

NOTE ON DISSOLUTION OF MARRIAGE OR ITS ANNULMENT, PROOF OF NON-EXISTENCE OF MARRIAGE, LEGAL SEPARATION OR TERMINATION OF SEPARATION

Death of one of the spouses

Death of wife - date of death / discovery of body (dd/mm/yyyy) ..

Death of husband - date of death / discovery of body (dd/mm/yyyy)

Number of death certificate

Divorce

Name of court

Date of court decision (dd/mm/yyyy)

Case reference number

Date on which court decision became final (dd/mm/yyyy)

Annulment of marriage

Name of court

Date of court decision (dd/mm/yyyy)

Case reference number

Date on which court decision became final (dd/mm/yyyy)

Proof of non-existence of marriage

Name of court

Date of court decision (dd/mm/yyyy)

Case reference number ..

Date on which court decision became final (dd/mm/yyyy)

Legal separation

Name of court

Date of court decision (dd/mm/yyyy)

Case reference number ..

Date on which court decision became final (dd/mm/yyyy)

Termination of separation

Name of court

Date of court decision (dd/mm/yyyy)

Case reference number ..

Date on which court decision became final (dd/mm/yyyy)

Portugal

Time of marriage

Comments on the marriage certificate

Dissolved due to death of spouse A/B on … (date)

Dissolved due to divorce on … (date)

Annulled on … (date)

Marriage declared null and void on … (date)

Declared non-existent on … (date)

Legal separation on … (date)

Reconciliation of spouses on … (date)

Conversion of legal separation into divorce on … (date)

Place of birth

Habitual residence

Child of A

Child of B

Place of birth

Habitual residence

Child of A

Child of B

Romania

Marriage certificate No / dated (dd/mm/yyyy)

Registered at (Locality/Embassy/Consulate/County)

Place of birth

Personal Identification Number

Parents’ details

Father’s surname

Father’s first name

Mother’s surname

Mother's first name

Place of birth

Personal Identification Number

Parents’ details

Father’s surname

Father’s first name

Mother’s surname

Mother's first name

REMARKS

Requires official translation

Yes

No

Sweden

National identification No

Citizenship

Place of birth

Middle name

Confidential personal data

National identification No

Citizenship

Place of birth

Middle name

Confidential personal data

Slovenia

Serial number of the document

Personal Identification Number

Place of Birth

Personal Identification Number

Place of Birth

Notes

Slovakia

Marriage certificate

Register of marriages

Place of issue

Full name of registrar

signature

volume

year

Page

Serial number

Personal Identification Number of the groom

Civil status of the groom

Forename of the groom’s father

Surname of the groom’s father

Surname at birth of the groom’s father

Forename of the groom’s mother

Surname of the groom’s mother

Surname at birth of the groom’s mother

Personal Identification Number of the bride

Civil status of the bride

Forename of the bride’s father

Surname of the bride’s father

Surname at birth of the bride’s father

Forename of the bride’s mother

Surname of the bride’s mother

Surname at birth of the bride’s mother

Surname of the children of both spouses

Notes

ANNEX V – CAPACITY TO MARRY

Austria

Other names

Academic qualifications/professional titles

Place of residence

Registration of birth

Last marriage to

dissolved by

dissolved on/in

Last registered partnership with

dissolved by

dissolved on/in

Other names

Academic qualifications/professional titles

Place of residence

Registration of birth

Last marriage to

dissolved by

dissolved on/in

Last registered partnership with

dissolved by

dissolved on/in

Belgium

This certificate is valid for six months from the date of issue

Title of nobility

Pseudonym

National registration number

Civil status

Married

Unmarried

Divorced

Widowed

Date (dd/mm/yyyy) of the marriage/divorce/death

First name(s) and surname(s) of former spouse

This certificate does not determine the capacity of … to marry

Title of nobility

Pseudonym

National registration number

Civil status

Married

Unmarried

Divorced

Widowed

Date (dd/mm/yyyy) of the marriage/divorce/death

First name(s) and surname(s) of former spouse

Bulgaria

Marriage certificate issued to a Bulgarian citizen who married abroad

Civil registrar’s name [forename, family name]

Patronymic

Personal identity number

Family status

Patronymic

Personal identity number

Family status

The certificate is issued for a civil marriage concluded before the competent local authorities in [Country]

Cyprus

ID card/passport number

Czech Republic

Certificate of no impediment to marriage

Personal identification number

Personal status

Single

Divorced

Widowed

Terminated partnership

Residing at

Residing at

The certificate of no impediment to marriage is valid for six months.

Germany

Not stated

Divers

Place of residence (address)

Street and number/PO Box

Place and postal code

Country

Place and number of marriage register

Previous marriage

Name of previous spouse

Authority which dissolved marriage

Date marriage dissolved

Place marriage dissolved

Not stated

Divers

Place of residence (address)

Street and number/PO Box

Place and postal code

Country

Place and number of marriage register

Previous marriage

Name of previous spouse

Authority which dissolved marriage

Date marriage dissolved

Place marriage dissolved

Denmark

Address

Middle name(s)

Personal identification number

Address

Municipality of residence

Marital status

Single

Divorced

Widowed

It is attested that the conditions for marriage between the abovementioned people have been fulfilled.

Comments, including explanations of licences, exemption from probate, foreign marriage certificates or the application of foreign law

Marriage authority

Certificate is only valid for 4 months from date of issuance. Certificate is to be submitted to the marriage authority

Middle name(s)

Personal identification number

Address

Municipality of residence

Marital status

Single

Divorced

Widowed

Estonia

Person's name

Position

Signature

Seal or stamp

Personal identification code

Estonia

Undetermined

Other (specify)

Civil status

Never married

Divorced/Date (dd/mm/yyyy) of divorce

Widowed/ Date (dd/mm/yyyy) of spouse’s death

Undetermined

Place of residence

Street and number

City or town

Country

Date of commencement of residence at place of residence

Date residence in Estonia ended

The Republic of Estonia certifies that there are no hindrances to entering into this marriage.

The Republic of Estonia hereby certifies that no impediments to marriage exist until the date of expiry of residence at the place of residence in Estonia.

The Republic of Estonia hereby certifies that no impediments to marriage exist as of the date of commencement of residence at the place of residence in Estonia.

The Republic of Estonia certifies that no impediments to marriage exist; the person has not resided in Estonia.

Declared country of marriage

This certificate has been issued based on the data in the Estonian Population Registry, and is valid for six months from the date of issue.

Personal identification code

Estonia

Undetermined

Other (specify)

Civil status

Never married

Divorced/Date (dd/mm/yyyy) of divorce

Widowed/ Date (dd/mm/yyyy) of spouse’s death

Undetermined

Place of residence

Greece

Prefecture

pursuant to Article 1370 of the Civil Code, as amended by Law 1250/1982, in conjunction with Article 4 of Presidential Decree 391/1982.

Today, on …(day/month/year, in words and figures), a licence is hereby granted to…(full name), father’s forename: …, mother’s forename: …, mother’s maiden name: …, following the application dated…, to enter into their (first/second) marriage with…, father’s forename:… and mother’s forename…, mother’s maiden name:…, in a civil or religious ceremony at…(city hall or church).

Spain

Place of issue

Name and surnames of parent A

Name and surnames of parent B

Registration of birth in the Civil Register: place, volume, page

Marital status

Address

Validity of the certificate in time

Finland

Place of issue

Name and official capacity of person who issued document

Date on which the examination of the impediments to marriage was requested

State, according to the laws of which the impediments to marriage of the foreign fiancé(e) were examined

Certificate is given to the couple who take it to the marriage ceremony.

This certificate is valid for four months from the date of issue.

Last surname used before marriage

Municipality of residence at birth

Abroad

Unknown

Stateless

Not yet determined

Unknown

Personal identity number

Local registration authority

No registration authority in Finland

Confirmed by the Evangelical-Lutheran Church

Yes

No

Sequence number of marriage

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Civil status

Single

Divorced

Widow/widower

Divorced from registered partnership

Widowed from registered partnership

Membership of a religious community

NB: The above information on the foreign fiancé(e) is based on the individuals’ own declaration.

Last surname used before marriage

Municipality of residence at birth

Abroad

Unknown

Stateless

Not yet determined

Unknown

Personal identity number

Local registration authority

No registration authority in Finland

Confirmed by the Evangelical-Lutheran Church

Yes

No

Sequence number of marriage

Municipality of residence

No municipality of residence in Finland

Civil status

Single

Divorced

Widow/widower

Divorced from registered partnership

Widowed from registered partnership

Membership of a religious community

Further information on the fiancé(e) who is not in Finland’s population information system

Mother tongue

Country of residence

Spouse's declaration of their choice of surname

When requesting an examination of the impediments to marriage, the prospective spouses declared that upon marriage they will adopt a common surname or a common compound surname as referred to in sections 10-13 of the Act on Forenames and Surnames.

According to their declaration

spouse A would have the following surname after marriage

and spouse B would have the following surname after marriage

The surnames declared by the spouses are legally valid and may be entered in the population information system after the wedding.

The surnames declared by the spouses are not legally valid.

The officiant fills in the details of the marriage and communicates them to the population information system (does not apply outside Finland)

Date of marriage

Type of wedding

Church wedding

Civil wedding

Place of marriage

Officiant’s marriage number

Name of witness

The spouses have informed the person officiating at the wedding that they no longer want to change their surnames as declared when requesting an examination of the impediments to marriage. Therefore the spouses' surnames did not change on entering into marriage

Place and date, signature, name in capital letters, official capacity

To be completed by register office or parish that enters details of the marriage in the population information system

Spouse A’s surname after the marriage

Spouse B’s surname after the marriage

Date

Signature or stamp

France

The intention to marry was published as required by the law of the Member State the authority of which issued this document

Additional information: In accordance with the national law of the Member State the signing authority of which issued this public document (Article 171-1 et seq. of the Civil Code), the marriage of a French national and a foreigner, conducted in a foreign country, is valid:- if it was celebrated in accordance with the usual procedures of that country,- if the spouse was physically present during the celebration,- and if the substantive conditions provided for by the personal law of the foreign spouse allowing the celebration of this union are not contrary to French public policy. However, a marriage certificate issued by a foreign authority is only enforceable against third parties in France if it is entered in the French civil status registers (Article 175-1 of the Civil Code).

Ireland

Authorised Person

Issued in

This document is valid for 120 days

This document is valid for 180 days

Passport

Address

Lithuania

Certificate of non-impediment to marriage

Title of the head of the civil registry office

Signature

Forename and surname of official

Stamp

Information about the civil registry office

Addressee

Personal identification number

Place of residence

Family status

Malta

f/Director

The parent

Surname(s)

Forename(s)

The parent who gave birth to the child

Surname(s)

Forename(s)

I the undersigned, certify that, at the request of (…), a search has been carried out in the Indexes of Marriages, Indexes of Civil Unions and Indexes of Cohabitation kept in this Registry from (Year) to (Year) to ascertain whether an Act of Marriage, Act of Civil Union or a registered or declared Cohabitation is registered in this Office under the name of (…), son/daughter of (…) and (…), born in (…) on (Date) and that this search has revealed that no Act of Marriage, Act of Civil Union or registered or declared Cohabitation referring to the said (…) has been registered at the Malta Public Registry.

These records do not include any registrations held at the Public Registry in Gozo.

It is hereby also declared that marriages celebrated prior to the 1st October 1975 were registered in these Islands for record purposes only, and therefore, the attention of all is drawn to the possibility that a marriage contracted prior the said date by the said … may not be registered in this office.

Netherlands

Civil registration service of

Name of registrar

Signature

Habitual residence

Previous marriage with

Dissolved by

On

At

Habitual residence

Previous marriage with

Dissolved by

On

At

Poland

Certificate valid until (dd/mm/yy)

Forename, surname and position of the person who issued the document

Place where the document was drawn up

Stamp duty

not subject

exempt

collected

Surname at birth

Civil status

Never married

Divorced

Widowed

Married

Parents’ details

Mother

Forename(s)

Surname

Surname at birth

Father

Forename(s)

Surname

Surname at birth

Surname at birth

Portugal

Civil status

Child of A

Child of B

Habitual residence

The marriage may take place until … (date)

Civil status

Married

Unmarried

Divorced

Widowed

Other (to be specified)

Child of A

Child of B

Habitual residence

Sweden

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

Certificate of no-impediment valid until [date]

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

ANNEX VI – MARITAL STATUS

Austria

Other names

Academic qualifications/professional titles

Belgium

This consular certificate was issued on the basis of the information held by the Consulate-General on the date indicated below and is valid until evidence to the contrary. It is issued subject to any decision of the Belgian courts to the contrary.

Title of nobility

Pseudonym

National registration number

Address

Street and number/P.O. box

City and postcode

Country

Legal separation/date (dd/mm/yyyy) of the legal separation

Surname of spouse

Title of nobility

First name(s) of spouse

Surname(s) of former spouse

Title of nobility

First name(s) of former spouse

Surname(s) of deceased spouse

Title of nobility

First name(s) of deceased spouse

Registered partnership/date (dd/mm/yyyy) the partnership was registered

Surname(s) of partner

Title of nobility

First name(s) of partner

Dissolved registered partnership/date (dd/mm/yyyy) of the dissolution of the registered partnership

Surname(s) of partner

Title of nobility

First name(s) of partner

Bulgaria

Certificate of marital status, spouse and children

Civil registrar’s name [forename, family name]

Patronymic

Personal identity number

Information concerning the spouse and children (for 3.2.1.1 only)

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Number

Name: [forename, patronymic, family name]

Personal identity number/Date of birth

Spouse/Child

Date of death

Germany

Not stated

Divers

Marriage dissolved (dd/mm/yyyy)

Estonia

Person's name

Position

Signature

Seal or stamp

Personal identification code

Estonia

Undetermined

Other (specify)

Place of residence

Street and number and postal code

City or town

Country

Date of commencement of residence at place of residence

Additional address

Street and number and postal code

City or town

Country

Date additional address became effective

Person’s status

Living

Deceased

No data

Undetermined

Names

Forename(s)

Last name

Date name changed

Document type

Greece

Prefecture

Municipality

Family record number

Former family record number

Municipal unit

Information on: initial member of family record

S/N of family record member

Former S/N of family record member

Member status

Type of entry

Current surname(s)

Forename(s)

Sex:

Father’s forename

Father’s surname

Mother’s forename

Mother’s surname

Mother’s maiden name

Date (dd/mm/yyyy) of birth

Place and country of birth

Settlement of birth

Local or municipal community of birth

Municipal unit of birth

Municipality of birth

Town/city of birth

Prefecture of birth

Nationality

Date on which nationality was acquired

Date of entry in municipal register

Date of removal from register

Reason for removal

Special electoral number

Male register (decentralised administration, municipality, municipal unit, local or municipal community)

Number/year of male register (S/N, year)

Entry in the male register (type of entry)

Information on: spouse/partner

S/N of family record member

Former S/N of family record member

Member status

Type of entry

Current surname(s)

Forename(s)

Sex:

Father’s forename

Father’s surname

Mother’s forename

Mother’s surname

Mother’s maiden name

Date (dd/mm/yyyy) of birth

Place and country of birth

Settlement of birth

Local or municipal community of birth

Municipal unit of birth

Municipality of birth

Town/city of birth

Prefecture of birth

Nationality

Date on which nationality was acquired

Date of entry in municipal register

Date of removal from register

Reason for removal

Special electoral number

Male register (decentralised administration, municipality, municipal unit, local or municipal community)

Number/year of male register (S/N, year)

Entry in the male register (type of entry)

Information on: child

S/N of family record member

Former S/N of family record member

Member status

Type of entry

Current surname(s)

Forename(s)

Sex:

Father’s forename

Father’s surname

Mother’s forename

Mother’s surname

Mother’s maiden name

Date (dd/mm/yyyy) of birth

Place and country of birth

Settlement of birth

Local or municipal community of birth

Municipal unit of birth

Municipality of birth

Town/city of birth

Prefecture of birth

Nationality

Date on which nationality was acquired

Date of entry in municipal register

Date of removal from register

Reason for removal

Special electoral number

Male register (decentralised administration, municipality, municipal unit, local or municipal community)

Number/year of male register (S/N, year)

Entry in the male register (type of entry)

Information on: former spouse/partner / 1st spouse/partner

S/N of family record member

Member status

Type of entry

Current surname(s)

Forename(s)

Father’s forename

Father’s surname

Mother’s forename

Mother’s surname

Date (dd/mm/yyyy) of birth

Place and country of birth

Settlement of birth

Local or municipal community of birth

Municipal unit of birth

Municipality of birth

Town/city of birth

Prefecture of birth

Reason for removal

Register of marriage/registered partnership:

The certificate was issued (reason for issuing):

For any type of legal purpose

Other

Information on marriage

S/N (marriage act)

Volume (marriage register volume)

Year (year of marriage)

Registry (registry of marriage)

Local or municipal community/unit

Municipality

Prefecture

Town/city

Country

Date

Initial member’s degree of marriage

Spouse’s degree of marriage

Information on registered partnership:

S/N (registered partnership act)

Volume (volume in the registered partnership register)

Year (year of registered partnership)

Registry (registry of registered partnership)

Local or municipal community/unit

Municipality

Prefecture

Consulate

Country

Date (date of registered partnership)

Number of initial member’s registered partnership

Number of partner’s registered partnership

Comments

By order of the Mayor The Head of the Municipal Register

Spain

Civil Register: place, volume, page

Name and surnames of parent A

Name and surnames of parent B

Address

Finland

Visitor address

Postal address

Place and postal code

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Previous surnames

Previous surnames (after the age of 15)

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Municipality of residence at birth

Abroad

Unknown

Stateless

Not yet determined

Unknown

Personal identity number

Main place of residence

Address of residence

Place and postal code

Date of move (dd/mm/yyyy)

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Mother tongue

Marriage number

Separated

Spouse

Current surname

Previous surnames

Previous surnames (after the age of 15)

Forename(s)

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Date (dd/mm/yyyy) of birth

Is alive

Died, date of death (dd/mm/yyyy)

Place and country of birth

Municipality of residence at birth

Abroad

Unknown

Sex:

Female

Male

Nationality

Stateless

Not yet determined

Unknown

Personal identity number

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Marriage number

Croatia

Surname and forename of the official who issued the certificate

Function of the official who issued the certificate

Place of issue

OIB (Personal Identification Number)

Time of birth

Ethnicity

Registration district

District in which the birth was registered

Year of registration

Serial number under which the birth was registered

Date of registration

Information on the parents

Information on the father

Forename(s)

Current surname(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Information on the mother

Surname(s) before the marriage

Forename(s)

Current surname(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Note: The personal data shown are those entered in the register of births, taking into account any subsequent valid changes

Code number

Place of issue

Hungary

Issuing official

Place of issue

Name and position of competent official

Name and position of issuer

Mother’s name

In a registered partnership

Registered partnership terminated

Surviving partner of a registered partnership

Marriage dissolved

Registered partnership dissolved

Italy

Divorced - date of divorce from spouse or civil partner (dd/mm/yyyy)

Widowed - date of death of spouse or civil partner (dd/mm/yyyy)

Married - in a civil partnership

Latvia

Personal identification number

Netherlands

Place of issue

Name of designated official

Signature

Father

Mother

Address and place of residence

Resident until

Married to

Registered partner/date (dd/mm/yyyy) of the registered partnership

Registered partner of

Divorced from

Widow(er) of

No registered partnership

Divorced registered partner/date (dd/mm/yyyy) of termination/dissolution of the registered partnership

Divorced registered partner of

Surviving registered partner/date (dd/mm/yyyy) of death of registered partner

Surviving registered partner of

Other entries

Poland

Certificate valid until (dd/mm/yy):

Forename, surname and position of the person who issued the document:

Place where the document was drawn up:

Stamp duty:

not subject

exempt

collected

Parents’ details

Mother

Forename(s)

Surname at birth

Father

Forename(s)

Surname at birth

Sweden

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

In a registered partnership/Date on which registered partnership began

Widow(er) who was in a registered partnership

Ex-registered partner/Date on which registered partnership dissolved

ANNEX VII – REGISTERED PARTNERSHIP

Austria

Date

Other names

Academic qualifications/professional titles

Place of birth

Other names

Academic qualifications/professional titles

Place of birth

Belgium

Date (dd/mm/yyyy) of the partnership declaration

Title of nobility

Pseudonym

National registration number

Place and country of birth

Title of nobility

Pseudonym

National registration number

Place and country of birth

Cyprus

certificate of civil union

Marital status

Citizenship

Place of residence

Marital status

Citizenship

Place of residence

Czech Republic

Registered partnership certificate

Place of issue

Full name of registrar

Registry office where the registered partnership is registered

Volume

Year

Page

Serial number

Place and country of birth

Personal identification number

Personal status

Forename, surname and surname at birth of parents

Place and country of birth

Personal identification number

Personal status

Forename/s, surname and surname at birth of parents

NOTE

Germany

Surname(s) after dissolution of the registered partnership

Forename(s) at birth

Forename(s) before the registered partnership

Forename(s) during the registered partnership

Forename(s) after dissolution of the registered partnership

Place of birth

Not stated

Divers

Religion

Other details from the register

Notices

Birth, registered partner A

Registry office

Registration number

Surname(s) after dissolution of the registered partnership

Forename(s) at birth

Forename(s) before the registered partnership

Forename(s) during the registered partnership

Forename(s) after dissolution of the registered partnership

Place of birth

Not stated

Divers

Religion

Other details from the register

Notices

Birth, registered partner B

Registry office

Registration number

Denmark

Address…

Middle name(s)

Personal identification number

Place of registration of birth

Middle name(s)

Personal identification number

Place of registration of birth

Greece

Prefecture

Municipality

Street

Telephone

Details of registered partnership certificate (number/volume/year)

Date of declaration

Declarant (Part A or Part B)

Municipal/local community

Contract number

Surname of children

Father’s forename

Mother’s forename

Father’s surname

Mother’s surname

Nationality

Religion

Country of birth

City/town of birth (abroad)

Municipality of birth

Municipal/local community of birth

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

Municipality of registration

Population register number

Tax identification number

Social security number

Social security bodies

Father’s forename

Mother’s forename

Father’s surname

Mother’s surname

Nationality

Religion

Country of birth

City/town of birth (abroad)

Municipality of birth

Municipal/local community of birth

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

Municipality of registration

Population register number

Tax identification number

Social security number

Social security bodies

The declarant and

INFORMATION ON DECLARANT

Forename(s)

Surname

Place of domicile (street, number, postal code, municipal/local community, municipal unit, municipality, prefecture, country)

OBSERVATIONS

Finland

Visitor address

Postal address

Place and postal code

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Previous surnames

Previous surnames (after the age of 15)

Current surname

Previous forenames

Previous forenames (after the age of 15)

Current forenames

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Municipality of residence at birth

Abroad

Unknown

Country of birth

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Civil status

Single

Married

Separated

Divorced

Widow/widower

Registered partner

Divorced from registered partnership

Widowed from registered partnership

No data

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Number of registered partnership

Previous surnames

Previous surnames (after the age of 15)

Current surname

Previous forenames

Previous forenames (after the age of 15)

Current forenames

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Municipality of residence at birth

Abroad

Unknown

Country of birth

Personal identity number

Citizenship

Stateless

Not yet determined

Unknown

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Number of registered partnership

France

Modification date

Date of effect of modification

Date when the partnership was dissolved

partnership dissolved by death

partnership dissolved by marriage

partnership dissolved at the request of at least one of the partners

Date of effect of dissolution

Croatia

Surname and forename of the official who issued the certificate

Function of the official who issued the certificate

Place of issue

Registration district

Year of registration

Serial number under which the partnership was registered

District in which the partnership was registered

OIB (Personal Identification Number)

Place of birth

Nationality

OIB (Personal Identification Number)

Place of birth

Nationality

Notes

Classification number

File reference number

Place of issue

Hungary

Place of issue

Series

Name of the official who issued the extract from the civil status register

Position of the official who issued the extract from the civil status register

Unique civil status register electronic identifier

Forename(s) at birth

Place of birth

Unique civil status register electronic identifier

Forename(s) at birth

Place of birth

Notes

Ireland

Registered in the Registrar’s Office

Superintendent Registrar’s Registration Area

County

Issued in Pursuance of the Civil Registration Act 2004

Certified to be compiled from a register maintained under section 13 of the Civil Registration Act 2004

In accordance with the provision of the Civil Registration Act, 2004

To alter this certificate or to use it as altered is a serious offence

Issued by

Date of Civil Partnership

Signed by

Party 1

Party 2

Witness 1

Witness 2

Registrar

Other Surnames

Address

Future Address

Occupation

Civil Status

Mother

Father

Other Surnames

Address

Future Address

Occupation

Civil Status

Mother’s Forename & Birth Surname

Father’s Forename and Birth Surname

Italy

Certificate of record of civil partnership from civil status registers

Certificate of civil partnership based on entry in population register

Extract of record of civil partnership from civil status registers

Place of issue

First name and surname of official who drew up the record

Time of civil partnership

Place of birth

Details on birth certificate

Residence

Nationality

Annotations

First name and surname of witness

Date of birth of witness

Place of birth of witness

Residence of witness

Place of birth

Details on birth certificate

Residence

Nationality

Annotations

First name and surname of witness

Date of birth of witness

Place of birth of witness

Residence of witness

Place of issue

Luxembourg

Place and country of issue

Place and country of birth

Place and country of birth

Malta

Date Of The Act

MR No.

Declaration of the parties

We the undersigned hereby declare that we have in the presence of

and of the undermentioned witnesses contracted a civil union at

We the undersigned declare that we choose: *to adopt for both of us the surname of one of the parties in the civil union / *to retain our surname after the civil union / *to adopt the surnames of both parties in the civil union in this order. (*delete where not applicable)

Particulars of the witnesses

Witness 1

Name and Surname

Date (dd/mm/yyyy) of birth

Place of birth

Place of Residence

Witness 2

Name and Surname

Date and Place of Birth

Place of Residence

Witness 3

Name and Surname

Date and Place of Birth

Place of Residence

Witness 4

Name and Surname

Date and Place of Birth

Place of Residence

Signature of party to the civil union

Witnesses’ Signature

The above declarations were signed in my presence

Date of receipt of the Act.

Progressive number of Registration No.

Signature of Director or other officer authorized to act

Annotations/Addenda

Place of birth

Identification document

Place of Residence

Name and Surname of Father, and Name, Surname and Maiden Surname of Mother

Place of birth

Identification document

Place of Residence

Name and Surname of Father, and Name, Surname and Maiden Surname of Mother

Netherlands

This extract contains information relating to the original

Place of issue

Name of registrar

Signature

Place of birth

Place of birth

OTHER ENTRIES

Date and place of termination

Date and place of dissolution

Date and place of annulment

Date and place of conversion

Sweden

National identification No

Citizenship

Place of birth

Middle name

Confidential personal data

National identification No

Citizenship

Place of birth

Middle name

Confidential personal data

Slovenia

Serial number of the document

Personal identification number

Place of birth

Personal identification number

Place of birth

Notes

ANNEX VIII – CAPACITY TO ENTER INTO A REGISTERED PARTNERSHIP

Austria

Other names

Academic qualifications/professional titles

Place of residence

Registration of birth

Last marriage to

dissolved by

dissolved on/in

Last registered partnership with

dissolved by

dissolved on/in

Other names

Academic qualifications/professional titles

Place of residence

Registration of birth

Last marriage to

dissolved by

dissolved on/in

Last registered partnership with

dissolved by

dissolved on/in

Cyprus

ID card/passport number

Czech Republic

Certificate of legal capacity to contract registered partnership

Personal identification number

Personal status

Single

Divorced

Widowed

Terminated partnership

Residing at

Residing at

THE CERTIFICATE OF LEGAL CAPACITY TO CONTRACT REGISTERED PARTNERSHIP IS VALID FOR SIX MONTHS.

Germany

Not stated

Divers

Place of residence (address)

Street and number/PO Box

Place and postal code

Country

Previous registered partnership

Name of previous spouse

Authority which dissolved partnership

date of dissolution of partnership

place of dissolution of partnership

Previous marriage

Name of previous spouse

Authority which dissolved marriage

Date marriage dissolved

Place marriage dissolved

Not stated

Divers

Place of residence (address)

Street and number/PO Box

Place and postal code

Country

Previous registered partnership

Name of previous spouse

Authority which dissolved partnership

date of dissolution of partnership

place of dissolution of partnership

Previous marriage

Name of previous spouse

Authority which dissolved marriage

Date of dissolution of marriage

Place of dissolution of marriage

Estonia

Person's name

Position

Signature

Seal or stamp

Personal identification code

Civil status

Date

Place of residence

Street and number and postal code

City or town

Country

Date of commencement of residence at place of residence

Postal address

Street and number and postal code

City or town

Country

Date postal address became effective

Person’s status

Names

First name

Last name

Date

Document type

Ireland

Signature

Certificate of single status

Irish citizen

passport No

issued in

Irish citizen

passport No

issued in

Malta

f/Director

I the undersigned, certify that, at the request of (…), a search has been carried out in the Indexes of Marriages, Indexes of Civil Unions and Indexes of Cohabitation kept in this Registry from (Year) to (Year) to ascertain whether an Act of Marriage, Act of Civil Union or a registered or declared Cohabitation is registered in this Office under the name of (…), son/daughter of (…) and (…), born in (…) on (Date) and that this search has revealed that no Act of Marriage, Act of Civil Union or registered or declared Cohabitation referring to the said (…) has been registered at the Malta Public Registry.

These records do not include any registrations held at the Public Registry in Gozo

It is hereby also declared that marriages celebrated prior to the 1st October 1975 were registered in these Islands for record purposes only, and therefore, the attention of all is drawn to the possibility that a marriage contracted prior the said date by the said … may not be registered in this office.

f/Director

Sweden

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

ANNEX IX – REGISTERED PARTNERSHIP STATUS

Austria

Other names

Academic qualifications/professional titles

Germany

Not stated

Divers

Finland

Visitor address

Postal address

Place and postal code

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Previous surnames

Previous surnames (after the age of 15)

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Municipality of residence at birth

Abroad

Unknown

Stateless

Not yet determined

Unknown

Personal identity number

Main place of residence

Address of residence

Place and postal code

Date of move (dd/mm/yyyy)

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Mother tongue

Number of registered partnership

OTHER PARTY TO REGISTERED PARTNERSHIP

Current surname

Previous surnames

Previous surnames (after the age of 15)

Forenames

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Date of birth (dd/mm/yyyy)

Is alive

Died, date of death (dd/mm/yyyy)

Place and country of birth

Municipality of residence at birth

Abroad

Unknown

Gender

Female

Male

Citizenship

Stateless

Not yet determined

Unknown

Personal identity number

Registration authority

No registration authority in Finland

Municipality of residence

Abroad

Unknown

No municipality of residence in Finland

Number of registered partnership

Luxembourg

Place and country of issue

Marital status

Single

Divorced

Widowed

Address

Street and number/box

Place and post code

Country

INFORMATION ON THE PARTNER OF THE PERSON CONCERNED

Surname(s) at birth

Current surname(s)

Surname(s) before the act

Surname(s) following the act

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

Nationality

Marital status

Single

Divorced

Widowed

Address

Street and number/box

Place and post code

Country

Owing to the termination of the partnership

Term of the partnership from…to…

Owing to the marriage of the partner

Term of the partnership from…to…

Term of the partnership from…to…

Sweden

National identification No

Registration in national population register

Date

County

Municipality

Confidential personal data

Slovenia

Personal Identification Number of partner A

Surname of partner B

Forename of partner B

Personal Identification Number of partner B

Sex

Female

Male

Undetermined

Certificate of dissolution of registered partnership

ANNEX X – DOMICILE AND/OR RESIDENCE

Austria

Academic qualifications

Academic title (prefix)

Academic title (suffix)

Nationality

Travel document (if not an Austrian citizen)

Type of document

Document number

Date of issue

Expiry date

Issuing authority

Issuing State

Registered since

Secondary residence

Address

Street and number/PO Box

Postal code and place

Registered since

Secondary residence

Address

Street and number/PO Box

Postal code and place

Registered since

Secondary residence

Address

Street and number/PO Box

Postal code and place

Registered since

Belgium

This consular certificate was issued on the basis of the information held by the Consulate-General on the date indicated below and is valid until evidence to the contrary. It is issued subject to any decision of the Belgian courts to the contrary.

Title of nobility

Pseudonym

National registration number

Date (dd/mm/yyyy) of registration

Accommodation address

Residence within the consular jurisdiction of this post since (dd/mm/yyyy)

Request for new principal residence for

Place

Date (dd/mm/yyyy) of the request

Declared address abroad

Date (dd/mm/yyyy)

Street and number/P.O. box

City and postcode

Country

Departure declaration

Date (dd/mm/yyyy) of the declaration

Street and number/P.O. box

City and postcode

Country

Residence abroad

Date (dd/mm/yyyy)

Street and number/P.O. box

City and postcode

Country

Consular posting

Place

Country

P.O. box abroad

Date (dd/mm/yyyy)

Street and number/P.O. box

City and postcode

Country

Temporary absence

Date (dd/mm/yyyy)

Legal domicile

Street and number/P.O. box

City and postcode

Country

Long-term missing person

Date (dd/mm/yyyy)

Non-disclosable address

Date (dd/mm/yyyy) of the non-disclosure decision

Date (dd/mm/yyyy) the non-disclosure began

Date (dd/mm/yyyy) the non-disclosure ends

Postal address

Street and number/P.O. box

City and postcode

Country

Previous domicile/residence

Domicile

Street and number/P.O. box

City and postcode

Country

Residence

Street and number/P.O. box

City and postcode

Country

Bulgaria

Certificate of permanent address

Certificate of current address

Civil registrar’s name [forename, family name]

Patronymic

Personal identity number

Issued on date [day, month, year]

Issued on date [day, month, year]

Cyprus

Personal identification number

Father’s name

Father’s surname

Mother’s name

Mother’s maiden name

Czech Republic

Time of issue

APPLICANT

Surname(s)

Forename(s)

Date (dd/mm/yyyy) of birth

Place and country of birth

ID

Address of residence or another contact address

Date of death

Place of death

Nationality

Numbers of electronically readable IDs

Data box ID number

Identification ‘Address of the municipality office’

Address for service

Street and number/PO box

Locality and postcode

CONSENT TO PROVIDE DATA TO OTHER PERSONS

Date of the last change of any data

Place of issue

Serial number

Germany

Surname at birth

Not stated

Divers

ADDITIONAL INFORMATION ON THE PERSON CONCERNED

Doctoral degree

Religious name, pseudonym

MORE THAN ONE DWELLING

Address of second dwelling (s)

Status of the dwelling (designation as principal/second dwelling)

Denmark

Personal identification number

Date of registration of current address

Estonia

Person's name

Position

Signature

Seal or stamp

Personal identification code

Civil status

Married/Date (dd/mm/yyyy) of marriage

Never married

Divorced/Date (dd/mm/yyyy) of divorce

Widowed/ Date (dd/mm/yyyy) of spouse’s death

Undetermined

Nationality

Estonia

Undetermined

Other (specify)

Person’s status

Living

Deceased

No data

Undetermined

Names

Surname(s)

Forename(s)

Date name changed

Document type

Finland

Visitor address

Postal address

Place and postal code

Telephone number

Place of issue

The details given above correspond to the data recorded in the population information system

According to Section 38 of Government Decree 128/2010, the extract may be signed electronically.

Address details have been updated in the population information system since its creation in 1971. For the years 1971-82 the register contains only the person’s last two addresses. From 1983 onwards the system contains all the changes of address the person has notified.

Previous surnames

Previous surnames (after the age of 15)

Previous forenames

Previous forenames (after the age of 15)

Forename normally used

Is alive

Died, date of death (dd/mm/yyyy)

Personal identity number

Civil status

Single

Married

Separated

Divorced

Widow/Widower

Registered partnership

Divorced from registered partnership

Widowed from registered partnership

No data

Date of move (dd/mm/yyyy)

Municipality of residence since (dd/mm/yyyy)

Abroad

Unknown

No municipality of residence in Finland

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