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Birth Certificate
Order Form

I need my own Birth Certificate I need the Birth Certificate of my minor child
I need the Birth Certificate of another person
(The possibility to purchase a birth certificate of another person is limited by the law.
Please indicate the reasons, why you need this document:

Questions, you don't know the answer: just let the field empty. But please bear in mind: Any information more you can deliver increases the chance to get the document you need.

Place of Birth
(Town, Canton, Bundesland, Department):
Country:
for other countries: Please ask me previously by e-mail
Birth Address (Hospital, Street etc.):
Date of Birth (Day, Month, Year):
Family Name of the child:
First Name(s) of the child:
Sex:
Nationality:
(Swiss citizens: Place/s of origin):
Name und First Name(s) of the Father:
Name und First Name(s) of the Mother:
By my signature I am authorising Mr. Renato Caccia to procure the above mentioned birth certificate.
Mit meiner Unterschrift beauftrage ich Herrn Renato Caccia mit der Beschaffung der obigen Geburtsurkunde oder Abstammungsurkunde.
Par ma signature, j'autorise M. Renato Caccia à se procurer l'acte de naissance susmentionné.
Con la presente autorizzo Sig. Renato Caccia a procurarsi l'Atto di Nàscita succitato.
Date: Signature: __________________________________

If you need the Birth Certificate in view of an administrative proceeding, please answer to the following questions:

What's the name of the authority which is
asking you for this birth certificate?
Address (if available)
or residence place of this
authority (City and Country):


Additional needs:

Birth Certificate on plurilingual international form

Consular Legalization or Apostille for the following country:

Translation of the Birth Certificate into the following language:

furthermore a notarial legalization of the translation

furthermore a consular Legalization or Apostille for the translation


The Birth Certificate should be sent to the following address:
 Delivery by DHL (supplement EUR 60.00)

Name und First Name / Company:
Postal address (street and n° or P.O. Box)
Postal Code, Town and Country:
Your fax n°
Your phone n°
Your e-mail address


Fees:
If you feel uncertain about your needs or about the fees in your particular case, ask for an estimate by e-mail

I enclose the following amount in cash
I'll pay the fees by credit card. My Card number is: its expiry date is (Month/Year) /
I'll pay the fees online by credit card. Please inform me how to do it.
I paid the fees by "Western Union". The "Money Transfer Control Number" MTCN is as follows:
I enclose a bank or personal check

Please fill in this form, print it out, sign it and send it by post or fax to:
Renato Caccia, Wehntalerstr. 115, 8057 Zurich, Switzerland
Fax from Switzerland: 044 361 70 16; Fax from other countries: +4144 361 70 16
or scan the signed order form and send it by e-mail: renaca@bluemail.ch
Please enclose a copy of your passport, your ID-card or any other official ID-document.

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