Gender Recognition Register (Northern Ireland) Regulations 2005 No. 187

SCHEDULE 1 PARTICULARS TO BE ENTERED IN GENDER RECOGNITION REGISTER WHERE THE BIRTH WAS REGISTERED IN NORTHERN IRELAND

PART 1 particulars to be entered where the record of the birth was created on or before 30th September 1973

• Birth Registered in the District of

• in the Superintendent Registrar’s district of

• in the county of

• Entry number

• Date and Place of birth

• Name (if any) (child’s forename(s))

• Sex

• Name and Surname and Dwelling-place of Father

• Name and Surname and Maiden Surname of Mother

• Rank or Profession of Father

• Signature, Qualification and Residence of Informant

• When Registered

• Signature of Registrar

• Baptismal Name if added after Registration of Birth and Date