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Application for a copy birth certificate


Before completing this form please note that Penallta House register office can only issue a replacement certificate if they hold the register containing the original entry. If not, you must apply to the register office that holds the original record.
 
Fields marked * are mandatory

Details of person applying for the replacement certificate

Title *
Title
How do you wish to be contacted regarding this application? *
How do you wish to be contacted regarding this application?
Are you applying for your own birth certificate? *
Are you applying for your own birth certificate?
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