The collection of information on this form is authorised by the Births, Deaths and Marriages Registration Act 2003. It is used for the purpose of the Act which includes registering deaths in Queensland and issuing death certificates.
The information on this form may be provided to law enforcement agencies and to the government and non-government agencies for verification of data. Access to this information or to a certificate may be granted to any person who has had an adequate reason to obtain it, or who meets the requirements of the access policy. To obtain details about the access policy and rights of access to this information contact the registry 1300 366 430. For general information about the registry visit www.justice.qld.gov.au.
*All items are marked with an asterisk (*) are for statistical or administrative purposes only. These will not appear in the register of Deaths.