Guardian Funeral - Death Certificate

Registration of Death Details

Details needed for Death Certificate

Many families ask why we need to know this information. It is needed to get the official death certificate so that the estate can be administered. If you feel that you do not wish to record any information, or it is unknown, please mark it as 'not recorded'.

We are here to assist you, so if you have any questions please ring (04) 237-5332 at any time.

Please fill out this form and post it to Guardian Funeral Home, 6 Norrie Street, North City, Porirua, or send it directly to us using the button at the bottom of the page.

FULL Name of Deceased
Birth name if different from above
Age and Date of Birth
Place of Birth (Town/City/Village and Country)
If not born in New Zealand:
number of years in NZ
Usual home address
Occupation of Deceased (pre-retirement)
Sex
Parents
Mother's Full Name
Mother's Maiden Name
Mother's Occupation (before retiring)
Father's Full Name
Father's Occupation (before retiring)
Relationship status at time of death:
Most recent Marriage or Civil Union:
Name of Spouse or Partner
Place and Country of Marriage or Civil Union
Age of Deceased at Marriage or Civil Union
Their Maiden Name if applicable
Sex of Spouse / Partner and their age if living	Sex Age
2nd Most recent Marriage or Civil Union:
Name of Spouse or Partner
Place and Country of Marriage or Civil Union
Age of Deceased at Marriage or Civil Union
Their Maiden Name if applicable
Sex of Spouse / Partner and their age if living	Sex Age
3rd Most recent Marriage or Civil Union:
Name of Spouse or Partner
Place and Country of Marriage or Civil Union
Age of Deceased at Marriage or Civil Union
Their Maiden Name if applicable
Sex of Spouse / Partner and their age if living	Sex Age
Ages of Children:
Male
Female
Ethnic Group:
Was Deceased descended from NZ Maori?
Do any of the following apply to the Deceased?
Justice of the Peace
Marriage Celebrant
Hold an Honour or Award
Name of Honour(s) or Award(s)