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 Amendment of Birth Certificate - Ref. no:  

I am writing with the intention to make a formal request for the amendment of the official death certificate of [insert name of the passed one].

I, ACCOUNT_FIRST_NAME ACCOUNT_LAST_NAME, am the [insert relationship with the passed one] of the person.

Below are a list of amendments that I would like to make:

口 Name

Old Name: [insert old name]

New Name: [insert new name]

口 Gender

Old Gender: [Male]/[Female]

New Gender: [Male]/[Female]

口 Birthday

Old Birthday: [Day]/[Month]/[Year]

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