Ontario Birth Certificate Order Form

Ontario Birth Certificate Order Form

This application is to obtain a Birth Certificate for individuals who were born in Ontario.
Applicant Name*

First NameLast Name
Applicant Mailing Address*

Street Address

Street Address Line 2

CityProvince/State

Postal/Zip CodeCountry
Applicant Email Address*
example@example.com
Applicant Phone Number*

Area CodePhone Number

Mother's Name*

First NameMiddle Name (enter N/A if not applicable)Last Name At Birth
Other last names used by the mother (if applicable)
Mother's address at time of birth

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's status at time of birth*

SingleMarriedDivorcedWidowedCommon Law
Mother's Age at Time of Birth
Mother's Date of Birth*

YearMonthDay
Date
Mother's City of Birth*
Mother's Province/State of Birth
Mother's Country of Birth*

Guarantor Information:

You must complete this section in full. Applications with missing guarantor information will not be processed. A guarantor is not required for subjects younger than 9 years old. A guarantor must be a Canadian citizen, known you for at least two years, hold an occupation from the list below, be a practicing member in good standing, and not retired. If the individual is retired or nonpracticing he/she is not valid as a guarantor. The guarantor may be related to you, provided he/she fulfils all of the aforementioned requirements. You must receive permission from the guarantor to provide his/her information. There is no requirement for the guarantor to sign the application.
Guarantor Name

First NameLast Name
Guarantor Occupation
Guarantor's Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guarantor's Phone Number

Area CodePhone Number

Guarantor Information: