ACCOUNT_FIRST_NAME  ACCOUNT_LAST_NAME

ACCOUNT_ADDRESS_SINGLE_LINE

ACCOUNT_PHONE_NO ACCOUNT_EMAIL

To AUTHORITY, 

ADDRESS

25 November 2024

Dear Sir or Madam, 

Re: Request for Birth Certificate - Ref. no:  

I am writing with the intention to make a formal request for my official birth certificate for the purpose of [insert purpose]. 

My full name is ACCOUNT_FIRST_NAME ACCOUNT_LAST_NAME. I am a [Male]/[Female]. 

I would like to request for my:

口 Short Form Birth Certificate 

口 Long Form Birth Certificate (certified)

........................................