Do It Yourself Guide to Identification - page 17

Cert i f icates
BIRTH
17
Do It YourselfGuide to Identification
Northwest Territories
Purchase
Pay by
Inperson
Cash (in-persononly)
Bymail
Interact/Debit (in-persononly)
By fax
Cheque
Money order
Visa
MasterCard
Cost:
$10.00 (Regular)
* for themost current cost please check
thewebsite
$20.00 (Long format)
Required Information
Surname
 (last name, givenmaiden name if
certificate is for amarriedwoman)
Placeof birth
 (city, town, village andprovince)
All given name(s)
Surname, and all givenname(s)
 of father, if applicable
Gender:maleor female
Surnameofmother (maiden name),
 and all given name(s) ofmother
Dateof birth
Mother and father’s placeof birth
Additional InformationRequested
Name, address and telephone number of applicantmust beprovided
Relationship topersonnamedoncertificateand reason for requestingacertificate
Methodof payment
Contact Information
Website:
Tel: 1-800-661-0830
Fax: (867) 777-3197
MailingAddress: Department of Health and Social Services
Government of theNWT
Bag#9 (107MacKenzieRoad/IDCBuilding, 2
nd
Floor)
Inuvik, NTX0E 0T0
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