Additional Health Department Forms

Forms for Vital Statistics and Registry

For the General Public (Para el publico en general)
Form # Form Name/Title Linked File Instruction/ Comments
REG-2 Delegation of Authority to Receive Certified Copy of Vital Record (Birth/Death)
(Updated December 26, 2017)
pdf (72k)
doc (18k)
 
REG-3 Delegation of Authority to Receive Certified Copy
(Marriage/Civil Union)
(Updated December 26, 2017)
pdf (73k)
doc (18k)
 
REG-7E Application for a Certified Copy of a "No Record of Marriage" Statement (English/Spanish)
(Updated November 23, 2016)
pdf (1229k)
 
REG-15 Application to Amend a New Jersey Vital Record /
Application for a Certified Copy of Amended Record
(Updated February 7, 2019)
pdf (179k)
doc (32k)
 
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-27A Application for a Non-Genealogical Certification or Certified Copy of a Vital Record
(English, fillable PDF with instructions)
(Updated April 30, 2019)
pdf (391k)
 
REG-27B APLICACIÓN PARA COPIAS CERTIFICADAS Ó CERTIFICACIONES DE REGISTROS CIVILES NO-ANCESTRO
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
pdf (301k)
 
REG-28A Application for a Genealogical Certification or Certified Copy of a Vital Record
(fillable PDF, English, with instructions)
(Updated May 9, 2018)
pdf (301k)
 
REG-28B APLICACIÓN POR UNA COPIA CERTIFICADA Ó CERTIFICACIONES DE UN REGISTRO CIVIL ANCESTRO
(fillable PDF, Español con Instrucciones)
(Updated May 9, 2018)
pdf (325k)
 
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)
Instructions (doc 38k)
 
REG-43 Transmittal of Court Order of Paternity
(Updated February 7, 2019)
pdf (638k)
NEW! Fillable PDF Form  
REG-44 Report of Adoption
Registrar una Adopción
(Updated February 7, 2019)
pdf (74k)
doc (23k)
English Instructions
español Instrucciones
 
REG-64 Consent for Artificial Insemination
(Updated December, 2015)
pdf (2724k)
 
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)
Guidelines (Guia), (English/español) (REG-D34) (doc 37k)
 
REG-77 Application for License: Marriage, Remarriage, Civil Union, or Reaffirmation of Civil Union
(Updated April 8, 2019)
pdf (28k)
doc (28k)
 
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 April 4, 2019)
pdf (140k)
doc (35k)
 
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 April 20th, 2022)
REG-D30 (160k)
 
REG-D30A "Entering into a Marriage or Civil Union in New Jersey" Brochure (Spanish)
(Updated April 20th,2022)
REG-D30a (663k)
 
REG-D30B "Entering into a Marriage or Civil Union in New Jersey" Brochure (Russian)
(Updated April 20th, 2022)
REG-D30b (815k)
 
REG-D30C "Entering into a Marriage or Civil Union in New Jersey" Brochure (Korean)
(Updated April 20th, 2022)
REG-D30c (701k)
 
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)
 
REG-L2 Request Form and Attestation to Amend Sex Designation on a Birth Certificate for an Adult to Reflect Gender Identity
pdf (120k)
 
REG-L3 Parent/Guardian Request Form and Attestation to Amend Sex Designation on a Birth Certificate for a Minor to Reflect Gender Identity
pdf (168k)
 
For Professional Partners (Para Socios Profesionales)
Form # Form Name/Title Linked File Instruction/ Comments
REG-1 Quarterly Report of Domestic Partnerships Registered
(Updated April 2, 2018)
pdf (22k)
doc (17k)
 
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-33 Short Form Birth Certificate
(Replaces the REG-42D (1) and REG-42D (2))
(Updated February 7th, 2022)
REG-33 (52k)
 
REG-33b Short Form Birth Certificate Version B
(Replaces the REG-42D (1) and REG-42D (2))
(Updated February 7th, 2022)
REG-33b (62k)
 
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) Instructions for Completing REG-34
Amendment to NJ Vital Record Form
(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-37A Application for Non-Genealogical Certification or Certified Copy of a Vital Record for Local Use
(fillable PDF, English, with instructions)
(Updated October 5, 2017)
NEW FORM!
Instructions for Local Registrars
(pdf 105k) The forms are now ONLY available for download on the EDRS System.  
REG-37B APLICACIÓN PARA COPIAS CERTIFICADAS Ó CERTIFICACIONES DE REGISTROS CIVILES NO-ANCESTRO for Local Use
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
NEW FORM!
Instructions for Local Registrars
(pdf 105k)
The forms are now ONLY available for download on the EDRS System.
 
REG-38A Application for Genealogical Certification or Certified Copy of a Vital Record for Local Use
(fillable PDF, English, with instructions)
(Updated October 5, 2017)
NEW FORM!
Instructions for Local Registrars
(pdf 105k) The forms are now ONLY available for download on the EDRS System.  
REG-38B APLICACIÓN POR UNA COPIA CERTIFICADA Ó CERTIFICACIONES DE UN REGISTRO CIVIL ANCESTRO
(fillable PDF, Español con Instrucciones)
(Updated October 5, 2017)
NEW FORM!
Instructions for Local Registrars
(pdf 105k)
The forms are now ONLY available for download on the EDRS System.
 
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)
Instructions (doc 38k)
 
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 February 7, 2019)
pdf (638k)
NEW! Fillable PDF Form  
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 May 25, 2023)
REG-62 (192k)
 
REG-66 Log of Voided Certified Copy Forms
pdf (10k)
doc (57k)
 
REG-69 Quarterly Report of Non-EDRS Burial Permits Issued
(Updated April 2, 2018)
pdf (22k)
doc (18k)
 
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