Fill in a note a change of name in a birth or adoption register application form

1. Can you note a change of name?

   1. Was your birth or adoption registered in Queensland? *

      • Yes
      • No
   2. Is the name you want noted the same as the name on your birth certificate? * (If you chose 'Yes' above)

      • Yes
      • No
   3. If noting a change of name for a child—are both parents able to sign the form? * (If you chose 'No' above)

      • Yes / Not applicable
      • No
   4. Have you registered a change of your name in Queensland the last 12 months? * (If you chose 'Yes' above)

      • Yes
      • No
   5. Do you have all the proof you need for identification? * View the proof you will need to provide. (If you chose 'No' above)

      • Yes
      • No
   6. By using this online service and by providing an email address and mobile number, I consent to the use of that email address and mobile number for the Registry of Births, Deaths and Marriages (RBDM) to provide information and for contact using SMS and email that relates to this application. I understand that it is my responsibility to ensure that I have nominated a secure email address for RBDM to send correspondence to, and I acknowledge that it is my responsibility to ensure the security of that information when received.
2. Fill in your application form Fill in the application before downloading and printing it.

   1. New name to be noted

      1. If you are changing your name back to the latest name on your birth certificate—for example, if you are changing your surname after divorce back to your maiden surname (i.e. Jane Doe to Jane Doe)—no note will be made.
         
         Find out about changing your name after marriage, separation or divorce.
      2. Your new name—due to a change of name in another state, or by deed poll or court order

         1. First name *
         2. Middle name(s)
         3. Family name * If your new name didn’t include a family name and you only use the name(s) above, enter n/a.
      3. What evidence do you have of your change of name? * For example, deed poll or court order.
   2. Previous change(s) to your name

      1. Have you changed your name previously since your birth or adoption? * For example, if the name on your current identification is different to your name as it appears on your birth certificate.

         • Yes
         • No
      2. Other names used (If you chose ‘Yes’ above)

         1. Name change 1

            1. First name *
            2. Middle name(s)
            3. Family name * If your name didn’t include a family name and you only used the name(s) above, enter n/a.
         2. Name change 2

            1. First name
            2. Middle name(s)
            3. Family name If your name didn’t include a family name and you only used the name(s) above, enter n/a.
         3. Name change 3

            1. First name
            2. Middle name(s)
            3. Family name If your name didn’t include a family name and you only used the name(s) above, enter n/a.
         4. For additional names, I will provide the details on a statutory declaration.
   3. Birth details

      1. Your name As shown on your birth certificate.

         1. First name *
         2. Middle name(s)
         3. Family name * If your birth name didn’t include a family name and you only use the name(s) above, enter n/a.
      2. Place of birth

         1. Town or city *
         2. State or territory *
      3. Date of birth * dd/mm/yyyy
   4. Marriage or civil partnership details of person noting change

      1. Current (or most recent) marriage or civil partnership Date of marriage or civil partnership.
      2. Place of marriage or civil partnership

         1. Town or city
         2. State or territory
         3. Country
      3. Your name on the marriage or civil partnership

         1. First name
         2. Middle name(s)
         3. Family name If your name didn’t include a family name and you only used the name(s) above, enter n/a.
      4. Date of any previous marriage or civil partnership
      5. Place of marriage or civil partnership

         1. Town or city
         2. State or territory
         3. Country
      6. Your name on the marriage or civil partnership

         1. First name
         2. Middle name(s)
         3. Family name If your name didn’t include a family name and you only used the name(s) above, enter n/a.
      7. For additional marriage or civil partnership details, I will provide the details on a statutory declaration.
   5. Your parents' details

      1. Mother's name As shown on your birth certificate.

         1. First name *
         2. Middle name(s)
         3. Maiden surname must be completed. The mother's maiden surname is the same as her surname or family name when she was born.
         4. Maiden surname * If your mother's name didn’t include a family name and they only used the name(s) above, enter n/a.
      2. Father or parent's name As shown on your birth certificate, if no father or parent is on your birth certificate enter n/a.

         1. First name *
         2. Middle name(s)
         3. Family name * If your father or parent's name didn’t include a family name and they only used the name(s) above, enter n/a.
      3. Have your parents' names changed since your birth? *

         • Yes
         • No
      4. Other names your parents have used (If you chose ‘Yes’ above)

         1. Other names of parents

            1. First name *
            2. Middle name(s)
            3. Family name * If your parent's name didn’t include a family name and they only used the name(s) above, enter n/a.
         2. Other names of parents

            1. First name
            2. Middle name(s)
            3. Family name If your parent's name didn’t include a family name and they only used the name(s) above, enter n/a.
   6. Who is applying?

      1. Are you applying on behalf of someone else? *

         • Yes
         • No
      2. Relationship to person noting a new name * (If you chose 'Yes' above)

         • Mother
         • Father
         • Parent
         • Legal guardian (evidence required)
         • Other
      3. * Your relationship to person noting a new name (If you chose ‘Other’ above)
         

         Extra evidence required

         
         You will need to provide evidence of legal authority to apply.
      4. Your name (as shown on current proof of ID)

         1. First name *
         2. Middle name(s)
         3. Family name * If the applicant's name doesn’t include a family name and they only use the name(s) above, enter n/a.
      5. Home address

         1. Address line 1 *
         2. Address line 2
         3. Address line 3
         4. 1. Town, city or suburb *
            2. State or territory *
            3. Postcode *
         5. Country
      6. Is your postal address different to your home address? *

         • Yes
         • No
      7. Postal address (If you chose ‘Yes’ above)

         1. Address line 1 *
         2. Address line 2
         3. Address line 3
         4. 1. Town, city or suburb *
            2. State or territory *
            3. Postcode *
         5. Country
      8. Contact number * Mobile preferred
      9. Email *
      10. If this application is for a child, are both parents applying? * Please note, normally both parents must complete and sign this application if it relates to a child.

          • Yes
          • No / Not applicable
      11. Other applicant's name (If you chose ‘Yes’ above)

          1. Relationship to person noting a new name *

             • Mother
             • Father
             • Parent
             • Legal guardian (evidence required)
             • Other
          2. * Other applicant's relationship to person noting a new name (If you chose ‘Other’ above)
             

             Extra evidence required

             
             You will need to provide evidence of legal authority to apply.
          3. Name

             1. First name *
             2. Middle name(s)
             3. Family name * If the applicant's name doesn’t include a family name and they only use the name(s) above, enter n/a.
   7. Before submitting the application form *

      I agree that I will have another adult (18 or older) witness my signature and return my completed and printed application form with certified proof of ID and supporting documents to the Registry of Births, Deaths and Marriages.

      Your application is almost ready to be downloaded and printed

      
      
      

      Please take the time to look over the details you have provided.

You are not eligible

We can only note a change of name if your birth or adoption was registered in Queensland.

See a list of interstate and overseas registry offices.

Did you know

We can’t change a name back to the name on your birth certificate, where both names are the same (i.e. Jane Doe to Jane Doe).

You are not eligible

We can't change your name more than once in 12 months.

You are not eligible

We can't note your child’s name if both parents have not signed the application. You can contact us if you need more information about this:

Online: our general enquiry form.

By phone: local call* 13 QGOV (13 74 68)

International +61 7 3022 6100 (+10 hours UTC)

(Phone lines are open Monday–Friday, 8.30am–4.30pm)

*Costs may be higher from mobile phones and interstate.

You are not eligible

We can't note your change of name until you can prove your identity. You can contact us if you need more information about this:

Online: our general enquiry form.

By phone: local call* 13 QGOV (13 74 68)

International +61 7 3022 6100 (+10 hours UTC)

(Phone lines are open Monday–Friday, 8.30am–4.30pm)

*Costs may be higher from mobile phones and interstate.

Privacy notice
The Department of Justice and Attorney-General is collecting your personal information for the purpose of processing your application to note a change of name in the Birth Register or the Adopted Children's Register under section 20 of the Births, Deaths and Marriages Registration Act 2003. Unless required or authorised by law, your personal information will not be provided to any other third party without your consent. Access to this information or a certificate may be granted to any person who has adequate reason to obtain it, or who meets the requirements of the access policy.