New Brunswick Birth Certificate – Form

Step 1 of 5

Select your province or territory:(Required)

We're sorry, we can't assist residents of Quebec.

Birth information

Surname at birth (before marriage)(Required)

As it appears on the birth registration.

All given names(Required)

Sex(Required)

Date of birth(Required)

Format: yyyy-mm-dd (for example 1985-07-03)

Place of birth (City, Town or Village)(Required)

Parents' information

Maiden surname of mother / other parent(Required)

Given names of mother / other parent(Required)

City / Town of birth of mother / other parent(Required)

Province / State of birth of mother / other parent(Required)

Country of birth of mother / other parent(Required)

Father / other parent

The father / other parent is not listed on the birth registration

Surname of father / other parent(Required)

Given names of father / other parent(Required)

City / Town of birth of father / other parent

Province / State of birth of father / other parent

Country of birth of father / other parent(Required)

Certificate

Which certificate do you need?(Required)

Language of the certificate(Required)

New Brunswick issues the certificate in the language you choose.

Applicant's details

"Applicant" is the person who is completing this online request. An "Applicant" must enter their contact information so they can be contacted if problems arise with their request.

Surname(Required)

All Given Names(Required)

Daytime Telephone Number(Required)

Alternate Telephone Number

Email Address(Required)

Enter Email Confirm Email

Preferred Method of Correspondence(Required)

Applicant's mailing address

The delivery address is the location where the certificate(s) will be sent.

Country(Required)

Postal / Zip Code(Required)

Street Number(Required)

Apartment / Unit number

Street / PO Box(Required)

Province / State(Required)

City / Town(Required)

Delivery address is the same as the mailing address

Yes, send the certificate to the mailing address above

Applicant's delivery address