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-27 Application for a Non-Genealogical Certification or Certified Copy of a Vital Record
Aplicación Para Copias Certificadas ó Certificaciones de Registros Civiles No-Ancestro
(Combined English/español)
(Updated December 13, 2016)
pdf 53k
doc 58k
English Instructions (REG-27A)
(Updated January 3, 2017)
pdf 21k
doc 39k

Español Instrucciones (REG-27B)
(Updated January 4, 2017)
pdf 21k
doc 44k  
REG-28 Application for a Genealogical Certification or Certified Copy of a Vital Record
Aplicación Para Copias Certificadas ó Certificaciones de Registros Civiles Ancestro
(Combined English/español)
(Updated November 28, 2016)
pdf 53k
doc 56k
English Instructions (REG-28A)
(Updated January 12, 2017)
pdf 20k
doc 38k

español Instrucciones (REG-28B)
(Updated January 12, 2017)
pdf 20k
doc 41k  
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 15, 2016)
pdf 11k
doc 31k
 
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-37 Application for Non-Genealogical Certification or Certified Copy of a Vital Record (Local Use)
(Updated November 28, 2016)
pdf 53k
doc 58k
Instructions
(New: January 3, 2017)
pdf 20k
doc 39k  
REG-38 Application for Genealogical Certification or Certified Copy of a Vital Record (Local Use)
(Updated November 28, 2016)
pdf 53k
doc 56k
 
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