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WA Death Certificate – Application Form

Step 1 of 13

Applicant details

Surname(Required)

Given names(Required)

Phone(Required)

Please include country code if outside Australia

Email(Required)

Enter Email Confirm Email

As a Tax Invoice will be sent to this email address please ensure it is correct

Your residential address

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal address

Use my residential address for delivery?(Required)

Yes

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Was the death registered in Western Australia(Required)

Yes

Death certificates are only available if the death was registered in Western Australia. Please contact the state or country where the death was registered.

Are you the Parent, Child or Spouse of the deceased?(Required)

Yes

Letter of Authority required

If applying on behalf of another person, a Letter of Authority or other evidence of entitlement may be required. For further information the RBDM Certificate Access Policy can be viewed at WA.gov.au

Why do you need the certificate?(Required)

Please state the reason you require the certificate(Required)

Death details

Please complete the form below:

Surname of deceased(Required)

Given names of deceased

Date of death(Required)

Day

Month

Year

Place of death (Suburb/Town)

Select your identity documents

When applying for a Western Australian certificate, evidence of your identity must be provided. For overseas applicants, the Registry will consider equivalent overseas documents. Please ensure that you have these documents before continuing.

Please upload three different types of identity documents. Make sure to select a different option in each of the three upload sections to help us verify your identity.

Choose document 1(Required)

Choose document 2(Required)

Choose document 3(Required)

Australian driver's licence

(MUST provide copy of front and back)

Licence number(Required)

Driver's licence card number (located on front or back of card)(Required)

Surname(Required)

Given name(Required)

Middle name

Date of birth(Required)

Day

Month

Year

Select a state(Required)

Upload your identity images

You must upload images of the selected documents by choosing either:

One image containing all original documents
One image for each document
Multiple images (one at a time) for the same original document (eg front and back of Australian driver's licence)

Upload Australian driver's licence(Required)

Drop files here or

Max. file size: 2 GB.

Australian passport

You are required to provide your document details

Surname(Required)

Given names(Required)

Date of birth(Required)

Day

Month

Year

Travel document number(Required)

Upload your identity images

You must upload images of the selected documents by choosing either:

One image containing all original documents
One image for each document
Multiple images (one at a time) for the same original document (eg front and back of Australian driver's licence)

Upload Australian passport(Required)

Drop files here or

Max. file size: 2 GB.

Australian citizenship certificate

You are required to provide your document details

Family name(Required)

Given names(Required)

Date of birth(Required)

Day

Month

Year

Acquisition date(Required)

Day

Month

Year

Stock number(Required)

Medicare card

You are required to provide your medicare card details

Card number(Required)

Individual ref number(Required)

Full name(Required)

Card expiry(Required)

Day

Month

Year

Upload your identity images

You are required to provide your document details

Letter of authority

You must upload images of the selected documents by choosing either:

One image containing all original documents
One image for each document
Multiple images (one at a time) for the same original document (eg front and back of Australian driver's licence)

Letter of authority(Required)

Drop files here or

Max. file size: 2 GB.

Upload your identity images

You are required to provide your document details

Upload the files corresponding to what you have chosen in Choose document 1

You must upload images of the selected documents by choosing either:

One image containing all original documents
One image for each document
Multiple images (one at a time) for the same original document (eg front and back of Australian driver's licence)

Upload document 1(Required)

Drop files here or

Max. file size: 2 GB.

Upload your identity images

You are required to provide your document details

Upload the files corresponding to what you have chosen in Choose document 2

You must upload images of the selected documents by choosing either:

One image containing all original documents
One image for each document
Multiple images (one at a time) for the same original document (eg front and back of Australian driver's licence)

Upload document 2(Required)

Drop files here or

Max. file size: 2 GB.

Upload your identity images

You are required to provide your document details

Upload the files corresponding to what you have chosen in Choose document 3

You must upload images of the selected documents by choosing either:

One image containing all original documents
One image for each document
Multiple images (one at a time) for the same original document (eg front and back of Australian driver's licence)

Upload document 3(Required)

Drop files here or

Max. file size: 2 GB.

(Required)

I confirm that I am authorised to provide the personal details presented and I consent to my information being checked with the document issuer or official record holder via 3rd party systems for the purpose of confirming my identity. Click the checkbox to confirm.

WA Birth Certificate assistance, management and processing service.

Credit or Debit Card

Certificate type:	Death Certificate
Delivery time:	1–2 weeks (approx.)
Total	AUD 119.00

This price includes application management, processing and assistance costs, government fees and taxes. The certificate will be issued and sent directly by the Registry of Births, Deaths and Marriages (Western Australia), which forms part of the Department of Justice, to the address provided in your application.

ⓘ Delivery times may vary depending on government processing and postal services.

(Required)

I have read, understood and accept the privacy policy and the terms and conditions.