Form 89A
P. 77, rr. 19 and 38.
(Minute of order under section 13 of the Registration of
Births, Deaths and Marriages Act 1973 or section 13 (1)
or section 15 (1) of the Children (Equality of Status)
Act 1976)
ORDER
THE COURT ORDERS that the birth (or stillbirth) of
born (or stillborn) on
be registered under the
provisions of the Registration of Births, Deaths and
Marriages Act 1973 in accordance with the following
particularsC
or
in the case of a declaration under section 13 (1) of the
Children (Equality of Status) Act 1976Cthe Court declares
that the relationship of father and child exists between
the man named below and the child named belowC
or,
in the case of a declaration under section 15 (1) of the
Children (Equality of Status) Act 1976Cthe Court declares
that the woman named below is the mother of the child
named belowC
CHILD
(For place of birth or stillbirth state name of hospital
or house, street and street number, and town or
locality.)
Surname of child:
Other names of child:
Sex of child:
Date of birth (or stillbirth):
Place of birth (or stillbirth): (in full)
FATHER OF CHILD
(In the case of a child born or stillborn outside
marriage omit the following matter relating to the father
of the child unless a declaration is made under section
13 (1) of the Children (Equality of Status) Act 1976)
Surname:
Other names:
Occupation:
Date of birth:
Where born: (town or locality)
(State or country)
MOTHER OF CHILD
Surname:
Maiden surname:
Other names:
Date of birth:
Where born: (town or locality)
(State or country)
(In the case of a child whose mother and father were not
married to each other when the order of declaration was
made, omit the following matter.)
MARRIAGE OF PARENTS OF CHILD
When married to each other:
Where married: (town and locality)
(State or country)
PREVIOUS ISSUE OF SUCH MARRIAGE
Names (in full) of other children of
marriage
Date of birth
or stillbirth
of each child*
(*Enter ``Deceased'' if child died prior to date of
birth of child in respect of whom registration is sought
or ``stillborn'' if applicable.)
(Complete as in general form of minute of order under
Part 41 rule 11, Form 51.)