Commonwealth Consolidated Regulations Commonwealth Consolidated Regulations(regulation 5)
PARTICULARS OF PERSON WHO HAS DIED OR DISAPPEARED
| 1 |
Surname |
| 2 | Christian or given names |
| 3 | Date of death or date on which person
was last seen alive |
| 4 | Place of death or location of flying craft or ship
when person was last seen alive |
| 5 | Sex |
| 6 | Age at death or disappearance |
| 7 |
Place of birth |
| 7A. | Last known occupation |
| 8 | Usual place of residence |
| 9 |
Nationality |
| 10 | Conjugal status |
| 11 | Name of spouse |
| 12 | Names and ages of
living children |
| 13 | Father's full name |
| 14 | Mother's full name and maiden
surname |
MEDICAL
PARTICULARS
| *15 | Cause of death |
| *16 | Name of medical practitioner, coroner
or authority furnishing particulars |
PARTICULARS OF BURIAL/CREMATION ( omit
whichever is not applicable )
| *17 | Date of burial/cremation |
| *18 | Place of
burial/cremation |
PERSON FURNISHING PARTICULARS
| 19 | Surname |
| 20 | Christian
or given names |
| 21 | Usual place of residence and address (if any) for
correspondence |
| 22 | Relationship to deceased |
| 23 | Title or rank |
| 24 |
Occupation |
| 25 | Name of registering officer |
| 26 | Place of registration |
| 27 |
Date application received by registering officer |
* These particulars do not apply in the case of a person who has disappeared