Personal Profile Record

The Registrar of Deaths requires particulars relating to a deceased person. This information is not always readily available and this can lead to unnecessary stress for relatives. For your convenience, we therefore provide the Personal Profile form below.

You can either click the Send button below to have the information sent to us for safe keeping, or click on the Print button to print out the form which you can then keep it somewhere safe and let family members know that you've made some decisions.

Personal Profile Record

After printing this out, keep it somewhere safe and let family members know that you've made some decisions.

First Names
Last Names
Address
Birth Date
Birth Place
If not born in NZ – state year of arrival in NZ
Occupation
Full name of Father
Profession/Occupation of Father
Full name of Mother
Marital Status – i.e. Married, Widow, Widower, Divorced or De facto
Spouses Name
Spouses Age
Spouses Occupation
Age at time of Marriage
Place of Marriage
Son's Birth Dates
Daughters Birth Dates
 

I.C.Mark LTD

Funeral Home
545-547 Queen St,
Levin,


Avenue Crematorium
39 Avenue North Road,
Levin

Phone:
0800 ICMARK (0800 426 275)

Email:
markinc@xtra.co.nz

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