Fill in a withdraw from ending a civil partnership application form

1. Can you withdraw your application to end a civil partnership?

   1. Did you submit your application to end your civil partnership within the last 90 days? *

      • Yes
      • No
   2. Was your name listed as one of the partners in the relationship on the application form? * (If you chose 'Yes' above)

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

      • Yes
      • No
   4. By using this online service and providing email addresses and mobile numbers, I/we consent to the use of those email addresses and mobile numbers for the Registry of Births, Deaths and Marriages (RBDM) to provide me/us with electronic information and for contact using SMS and email that relates to this application. I/we understand that it is my/our responsibility to ensure that I/we have nominated secure email addresses for RBDM to send correspondence to. I/we acknowledge that it is my/our responsibility to ensure the security of that information when received.
2. Fill in your application form Fill in the application form before downloading and printing it.

   1. Civil partnership details

      1. Did you have a declaration ceremony? *

         • Yes
         • No
      2. (If you chose 'Yes' above)

         1. Place of declaration ceremony If a ceremony was conducted.
      3. Registration number (if known) Top right-hand corner of the certificate (e.g. 2016/0000).
      4. Date of registration/declaration ceremony (if known) dd/mm/yyyy
   2. Partner 1 details

      1. Place of birth

         1. Town or city *
         2. State or territory *
         3. Country Only include country if not Australia.
      2. Date of birth dd/mm/yyyy *
      3. Sex *

         • Female
         • Male
      4. Name

         1. First name *
         2. Middle name(s)
         3. Family name * If one name, enter n/a.
      5. Home address

         1. Current street address*
         2. 1. Town, city or suburb*
            2. State or territory*
            3. Postcode*
      6. Is your postal address the same as your home address? *

         • Yes
         • No
      7. (If you chose 'No' above)

         1. Partner 1's postal address

            1. Current postal address *
            2. 1. Town, city or suburb *
               2. State or territory *
               3. Postcode *
      8. Mobile number If you don't have a mobile, provide a daytime phone number. *
      9. Email address*
      10. Partner 1 parents' details
      11. Mother's name

          1. First name *
          2. Middle name(s)
          3. Family name * If one name, enter n/a.
      12. Father or registered parent's name

          1. First name *
          2. Middle name(s)
          3. Family name * If one name, enter n/a.
   3. Partner 2 details

      1. Place of birth

         1. Town or city *
         2. State or territory *
         3. Country Only include country if not Australia.
      2. Date of birth* dd/mm/yyyy
      3. Sex *

         • Female
         • Male
      4. Name

         1. First name *
         2. Middle name(s)
         3. Family name * If one name, enter n/a.
      5. Home address

         1. Current street address *
         2. 1. Town, city or suburb *
            2. State or territory *
            3. Postcode *
      6. Is your postal address the same as your home address? *

         • Yes
         • No
      7. (If you chose 'No' above)

         1. Partner 2's postal address

            1. Current postal address *
            2. 1. Town, city or suburb *
               2. State or territory *
               3. Postcode *
      8. Mobile number If you don't have a mobile, provide a daytime phone number. *
      9. Email address*
      10. Partner 2 parents' details
      12. Mother's name

          1. First name *
          2. Middle name(s)
          3. Family name * If one name, enter n/a.
      13. Father or registered parent's name

          1. First name *
          2. Middle name(s)
          3. Family name * If one name, enter n/a.
   4. Before returning the application form *

      I agree that my partner and I will bring our completed and printed application form and proof of ID to a Justice of the Peace before submitting the application form to the Registry of Births, Deaths and Marriages.

   5. Your form is almost ready to be downloaded and printed

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

We can't withdraw your application

The Registrar officially terminates your civil partnership 90 days after you submit the completed application to end it.

You are not eligible

This application must be lodged by one or both of the registered partners within the 90-day termination period.

You need to prove your identity

We can't withdraw your application to end your civil partnership until you can prove your identity. You can contact us to find out more.

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 withdraw from ending a civil partnership under the Births, Deaths and Marriages Registration Act 2003 and Civil Partynerships Act 2011. The information on this form may be provided to law enforcement agencies and to government and non-government agencies for verification of the data. 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.