<p> Commonwealth of Australia Marriage Act 1961</p><p>APPLICATION TO REGISTER THE LEGITIMATION OF A CHILD IN THE REGISTER OF LEGITIMATIONS (regulation 68 Marriage Regulations 1963 (Cth))</p><p>To: The Registrar of Births, Deaths and Marriages for the Australian Capital Territory.</p><p>Application is made by (full name, address and occupation of each applicant or of the applicant) to register in the Register of Foreign Legitimations the legitimation of (full name), 89 who is the legitimate child of his parents by virtue of section 90 of the Marriage Act 1961. 91 We are the parents of (or I am a parent of or I am the surviving parent of or I am the person who has obtained an order under section 92 of the Marriage Act 1961 relating to) the child. An official record of birth in respect of the child is furnished herewith. (or It is impracticable to obtain an official record of birth in respect of the child for the following reasons: .)</p><p>An official record of marriage in respect of the marriage of the parents of the child is produced herewith. (or It is impracticable to obtain an official record of marriage in respect of the marriage of the parents of the child for the following reasons: .) We I hereby declare that the information set out below in connection with this application is true and correct.</p><p>INFORMATION CONCERNING THE LEGITIMATED CHILD Surname Other names Sex Date of Birth (date and year) * Birthplace Place at which birth registered (if birth never registered in any country — state why birth not registered) If deceased, date of death (date and year)</p><p>INFORMATION CONCERNING THE PARENTS OF THE LEGITIMATED CHILD Father’s name in full † Father’s present address Father’s occupation * Father’s birthplace Mother’s maiden name in full Mother’s name (in full) at time of birth of child † Mother’s present address * Mother’s birthplace Date of marriage of father and mother Place of marriage * If born in Australia — city or town and State or Territory; if born outside Australia — city or town and country. † If father or mother, as case may be, now dead, write ‘deceased’.</p><p>‡ INFORMATION CONCERNING DOMICILE ‡ Father’s/Mother’s domicile at the time of his/her marriage to the other parent of the child ‡ Facts relied on as establishing Father’s/Mother’s domicile § Name of parent domiciled in Australia at relevant time for the purposes of section 91 (2) of the Marriage Act 1961 § Facts relied on as establishing domicile</p><p>‡ Omit if legitimation effected by s. 91 of Marriage Act 1961 or if order under of that Act obtained. § Omit if legitimation not effected by s. 91 of the Marriage Act 1961 or if order under s. 92 of that Act obtained.</p><p>║ INFORMATION CONCERNING ORDER UNDER SECTION 92 OF THE MARRIAGE ACT 1961 ║ Court by which order made ║ Date of order ║ Whether appeal instituted and, if so, result of appeal</p><p>║ Omit if no order made.</p><p>§ INFORMATION CONCERNING BELIEF IN VALIDITY OF VOID MARRIAGE § At the time of the intercourse that resulted in the birth of the child (or At the time when the ceremony of marriage took place), I believed that the marriage referred to above was valid. § Grounds for belief by applicant that marriage valid at the relevant time for the purposes of section 91 (1) of the Marriage Act 1961 § Circumstances in which applicant learned that marriage void.</p><p>Dated the (day) day of (month), (year).</p><p>(Signatures of Applicants)</p>