Vital Statistic Form

Thank you for contacting us.
We’ll get back to you as soon as possible.

We got it.

Information Required for Registration with Vital Statistics

First name This is required

Last name This is required

Email Enter an email Use an address with (@) and (.)

Phone number Enter your phone number Enter a valid number like +1555-123-4567

Address This is required

Social Insurance This is required

BC Care Card Number This is required

Date of Birth This is required rt.advancedFormInput.date.formatMessage

Occupation (Before Retiring) This is required

Industry Worked In This is required

Optional Information

Marital Status

Married

Divorced

Seperated

Widowed

Common Law

This is required

Name of Spouse (Including Maiden Name) This is required

Spouse's SIN if Married This is required

Date of Birth This is required rt.advancedFormInput.date.formatMessage

Place of Birth This is required

Name of Father This is required

Father's Place of Birth This is required

Name of Mother (Maiden Name) This is required

Mother's Place of Birth This is required

Name of Next of Kin/Executor This is required

Phone number Enter your phone number Enter a valid number like +1555-123-4567

Address of Next of Kin/Executor This is required

Disposition Preference

Cremation

Burial

This is required

Religion This is required

Church This is required

Clergy/Officiant This is required

Cemetery This is required

Newspaper This is required

Newspaper Notice/Special Wishes This is required

By checking this box, you agree to our Privacy Policy and consent to the use of your information.

This is required

Back

Next Submit

That didn’t work.

The form wasn’t sent. Please try again.

Get in touch

Vital Statistic Form

We got it.

Information Required for Registration with Vital Statistics

Optional Information

That didn’t work.

A Year of Grief Support