Additional Health Department Forms

Forms for Vital Statistics and Registry

For the General Public (Para el publico en general)
Form # Title PDF/WORD Instruction/ Comments
REG-2 Delegation of Authority to Receive Certified Copy of Vital Record (Birth/Death)
(Updated December 8, 2016)
pdf 14k
doc 32k
 
REG-3 Delegation of Authority to Receive Certified Copy
(Marriage/Civil Union)
(Updated November 23, 2016)
pdf 14k
doc 32k
 
REG-7E Application for a Certified Copy of a "No Record of Marriage" Statement (English/Spanish)
(Updated November 23, 2016)
pdf 22k
doc 114k
 
REG-15 Application to Amend a New Jersey Vital Record /
Application for a Certified Copy of Amended Record
(Updated March 8, 2017)
pdf 28k
doc 59k
 
REG-20 Authorization for Release of Cause of Death
Autorización para la Emision de Causa de Muerte
(Combined English and español)
pdf 18k
doc 38k
 
REG-27A Application for a Non-Genealogical Certification or Certified Copy of a Vital Record
(English, fillable PDF with instructions)
(Updated October 5, 2017)
pdf 322k
 
 
REG-27B APLICACIÓN PARA COPIAS CERTIFICADAS Ó CERTIFICACIONES DE REGISTROS CIVILES NO-ANCESTRO
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
pdf 301k
 
 
REG-28A Application for a Genealogical Certification or Certified Copy of a Vital Record
(fillable PDF, English, with instructions)
(Updated October 5, 2017)
pdf 257k
 
 
REG-28B APLICACIÓN POR UNA COPIA CERTIFICADA Ó CERTIFICACIONES DE UN REGISTRO CIVIL ANCESTRO
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
pdf 280k
 
 
REG-31 Consent of Parents or Guardian to Marriage or Civil Union of Minor
Consentimiento Paterno ó de Guardian Legal para Matrimonio o Unión Civil de un Menor
(Combined English/español)
pdf 89k
doc 50k
 
REG-36 New Records System for Birth Parents
Forms Package includes:
Form A, Contact Preference, and
Form B, Family History Information
(Updated January 1, 2017)
pdf 450k
doc 340k
 
REG-36A New Records System for Birth Parents
Form A, Contact Preference Form
pdf 27k
doc 62k
 
REG-36B New Records System for Birth Parents
Form B, Family History Information Form
pdf 44k
doc 172k
 
REG-41 Application for an Uncertified Copy of an Adopted Person's Original Birth Record pdf 18k
doc 41k
Instructions
pdf 16k
doc 38k  
REG-43 Transmittal of Court Order of Paternity
(Updated November 21, 2016)
pdf 16k
doc 35k
 
REG-44 Report of Adoption
Registrar una Adopción
(Updated November 21, 2016)
pdf 15k
doc 47k
English Instructions

español Instrucciones  
REG-59 Certificate of Sex Reassignment via Surgical Procedure
(Updated August 9, 2017)
pdf 184k
doc 19k
 
REG-64 Consent for Artificial Insemination
(Updated December, 2015)
pdf 13k
doc 33k
 
REG-68 Request to Place on File a Certificate of Birth Resulting in Stillbirth
(Solicitud para Archivar un Registro de Partida de Nacimiento Resultando en Parto Muerto)
pdf 14k
doc 36k
Guidelines (Guia), (English/español) (REG-D34)
pdf 31k
doc 37k  
REG-77 Application for License: Marriage, Remarriage, Civil Union, or Reaffirmation of Civil Union
(Updated November 1, 2016)
pdf 24k
doc 98k
 
REG-77A Application for License: Marriage, Remarriage, Civil Union or Reaffirmation of Civil Union (Combined English and Spanish)
(Solicitud Para Licencia: Matrimonio, Rematrimonio, Union Civil, o Reafirmacion de Union Civil)
(Updated November 23, 2016)
pdf 36k
doc 125k
 
REG-D7 Notice of Rights and Obligations of Domestic Partners pdf 21k
doc 38k
 
REG-D7A Notice of Rights and Obligations of Domestic Partners (Spanish) pdf 22k
doc 42k
 
REG-D30 "Entering into a Marriage or Civil Union in New Jersey" Brochure
(Updated June 2016)
pdf 14k
doc 31k
 
REG-D30A "Entering into a Marriage or Civil Union in New Jersey" Brochure (Spanish)
(Updated June 2016)
pdf 22k
doc 48k
 
REG-D30B "Entering into a Marriage or Civil Union in New Jersey" Brochure (Russian)
(Updated June 2016)
pdf 143k
doc 39k
 
REG-D30C "Entering into a Marriage or Civil Union in New Jersey" Brochure (Korean)
(Updated June 2016)
pdf 72k
doc 48k
 
REG-D33 "Registering a Domestic Partnership in New Jersey" Brochure pdf 15k
doc 30k
 
REG-D33A "Registering a Domestic Partnership in New Jersey" Brochure (español) pdf 23k
doc 47k
 
REG-D33B "Registering a Domestic Partnership in New Jersey" (Russian) pdf 121k
doc 41k
 
REG-D33C "Registering a Domestic Partnership in New Jersey" (Korean) pdf 120k
doc 49k
 
REG-D34 Guidelines for Requesting to Place on File a Certificate of Birth Resulting in Stillbirth (English/español)
(Updated November 21, 2016)
pdf 27k
doc 44k
 
For Professional Partners (Para Socios Profesionales)
Form # Title PDF/WORD Instruction/ Comments
REG-1 Quarterly Report of Domestic Partnerships Registered
(2016)
pdf 14k
doc 39k
 
REG-1 Quarterly Report of Domestic Partnerships Registered
(2017)
(Updated February 1, 2017)
pdf 14k
doc 50k
 
REG-5 Report of No Births, Marriages, Civil Unions, Domestic Partnerships or Fetal Deaths
(Updated April, 2016)
pdf 15k
doc 27k
 
REG-13 Certified Municipal Registrar Recertification Course Tracking Log
(Updated January, 2015)
pdf 13k
doc 56k
 
REG-14 Disinterment-Transit Permit pdf 14k
doc 44k
 
REG-23X Template for Electronic Remarriage License and Certificate
[Set up for Use on Traditional Laser Printers]
(New as of March 1, 2017)
 
doc 47k
 
REG-23X_MFP Template for Electronic Remarriage License and Certificate
[Set up for Use on Multifunction Peripheral (MFP) Devices]
(New as of March 1, 2017)
 
doc 49k
 
REG-24X Template for Electronic Marriage License and Certificate
[Set up for Use on Traditional Laser Printers]
(Updated March 1, 2017)
 
doc 55k
 
REG-24X_MFP Template for Electronic Marriage License and Certificate
[Set up for Use on Multifunction Peripheral (MFP) Devices]
(Updated March 1, 2017)
 
doc 56k
 
REG-25 Notification of Marriage/Civil Union
(Updated November 1, 2016)
pdf 11k
doc 27k
 
REG-26 Certificate of Fetal Death
(Updated November 1, 2016)
pdf 39k
doc 175k
 
REG-34 Amendment to New Jersey Vital Record of
Birth, Death, Fetal Death, Marriage, Remarriage, Civil Union, Domestic Partnership
(Replaces REG-35, REG-45, REG-56 and REG-60 Forms)
(Updated March 3, 2017)
pdf 16k
doc 52k
Instructions for Completing REG-34
Amendment to NJ Vital Record Form
pdf 20k
doc 28k  
REG-35 Correcting a Birth Record for Child Whose Natural Parents Married After Its Birth
(Replaced by revised REG-34 form on August 1, 2016)
 
 
 
REG-37A Application for Non-Genealogical Certification or Certified Copy of a Vital Record for Local Use
(fillable PDF, English, with instructions)
(Updated October 5, 2017)
 
 
NEW FORM!
Instructions for Local Registrars
pdf 105k

The forms are now ONLY available for download on the EDRS System.  
REG-37B APLICACIÓN PARA COPIAS CERTIFICADAS Ó CERTIFICACIONES DE REGISTROS CIVILES NO-ANCESTRO for Local Use
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
 
 
NEW FORM!
Instructions for Local Registrars
pdf 105k

The forms are now ONLY available for download on the EDRS System.  
REG-38A Application for Genealogical Certification or Certified Copy of a Vital Record for Local Use
(fillable PDF, English, with instructions)
(Updated October 5, 2017)
 
 
NEW FORM!
Instructions for Local Registrars
pdf 105k

The forms are now ONLY available for download on the EDRS System.  
REG-38B APLICACIÓN POR UNA COPIA CERTIFICADA Ó CERTIFICACIONES DE UN REGISTRO CIVIL ANCESTRO
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
 
 
NEW FORM!
Instructions for Local Registrars
pdf 105k

The forms are now ONLY available for download on the EDRS System.  
REG-40 Attestation to Birth Certificate
(Updated November 21, 2016)
pdf 39k
doc 48k
 
REG-41 Application for an Uncertified Copy of an Adopted Person's Original Birth Record pdf 18k
doc 41k
Instructions
pdf 16k
doc 38k  
REG-42D(1) Birth Template (One Parent)
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 28k
 
REG-42D(2) Birth Template (Parent, Parent)
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 29k
 
REG-42F(1) Marriage Template (long form with Parents' Names)
for use on REG-42A Certified Copy Paper
(Updated November, 2013)
 
doc 30k
 
REG-42F(2) Marriage Template (short form without Parents' Names)
for use on REG-42A Certified Copy Paper
(Updated November, 2013)
 
doc 28k
 
REG-42G Death Template
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 30k
 
REG-42H Domestic Partnership Template
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 29k
 
REG-42I (1) Civil Union Template (without Parent Names)
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 27k
 
REG-42I(2) Civil Union Template (with Parent Names)
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 31k
 
REG-42J Remarriage Template
for use on REG-42A Certified Copy Paper
(Updated October, 2013)
 
doc 29k
 
REG-42K Reaffirmation of Civil Union Template
for use on REG-42A Certified Copy Paper
(Updated April, 2014)
 
doc 29k
 
REG-43 Transmittal of Court Order of Paternity
(Updated November 21, 2016)
pdf 16k
doc 35k
 
REG-45 Request for Legal Name Change to Original Record of Birth, Marriage, Civil Union or Domestic Partnership
(Replaced by revised REG-34 form on August 1, 2016)
 
 
 
REG-56 Correcting a Birth Record for Out-of-Wedlock Child Whose Mother Married a Man Other Than the Natural Father
(Replaced by revised REG-34 form on August 1, 2016)
 
 
 
REG-60 Correcting the Birth Record of a Child Said to Have Been Born Out-of-Wedlock and Whose Natural Parents Have Not Married Each Other
(Replaced by revised REG-34 form on August 1, 2016)
 
 
 
REG-62 Request to Purchase Certified Copy of Vital Records Forms
(Updated March 18, 2014)
pdf 25k
doc 40k
 
REG-66 Log of Voided Certified Copy Forms pdf 10k
doc 57k
 
REG-69 Quarterly Report of Non-EDRS Burial Permits Issued
(2016)
(Updated March 11, 2016)
pdf 14k
doc 39k
 
REG-69 Quarterly Report of Non-EDRS Burial Permits Issued
(2017)
(Updated February 1, 2017)
pdf 14k
doc 39k
 
Go to Vital Statistics and Registry     Additional Health Department Forms