Application for birth certificate

*Applicant`s name and adress:

Name:

Adress:   

Postcode:

Tel:

E-mail address:


* Number of certificates or copies required:

Certificate
Copy:


*Details of birth:

Surname at birth:

Forenames:

Place of birth:

Father`s surname:

Mother`s maiden surname:

Mother`s forenames:

Additional information:

Details of birth record (if known):

Year:

Book:

Leaf:  

Record number

 
Name and delivery adress (name, adress and postcode of the person to whom you neeed the document to be sent – is very important that a postcode is provided):

Name:

Adress:

Postcode:

Payment details:

Send a cheque/ postal order expressed in euros made payable to ARQUIVO REGIONAL DA MADEIRA. If you would rather pay by money transfer, place the sumi n the following account: (IBAN: PT50 0019 0045 0020 0002 51094; bankcode SWIFT BBVAPTPL). Please advise of the transfer by mail or letter. The required document(s) will be sent only after confirmation that the payment has been duly credited.

* required fields

If you have any queries please contact us slc@arquivo-madeira.org