of April 19, 2012 No. 498
About approval of forms of assembly books of state registration of acts of civil status and forms of the certificates granted based on entries in these books
According to article 181 of the Code of the Republic of Kazakhstan of December 26, 2011 "About scrap (matrimony) and family" the Government of the Republic of Kazakhstan DECIDES:
1. Approve enclosed:
1) forms of assembly books of state registration of the acts of civil status which are drawn up based on assembly records: about the birth;
about paternity proof;
about marriage (matrimony);
about annulment of marriage (matrimony);
about adoption;
about change of name, middle name, surname;
about death;
2) forms of the certificates granted based on entries in assembly books of state registration of acts of civil status: about the birth;
about paternity proof;
about marriage (matrimony);
about annulment of marriage (matrimony);
about adoption;
about change of name, middle name, surname;
about death.
2. Recognize invalid some decisions of the Government of the Republic of Kazakhstan according to appendix to this resolution.
3. This resolution becomes effective after ten calendar days after the first official publication.
Prime Minister of the Republic of Kazakhstan K. Masimov
Approved by the order of the Government of the Republic of Kazakhstan of April 19, 2012 No. 498
№ _________
"___" ________________ years
Individual identification number _________
Information about the child
1. _________________________ 2 surname. Name ______________________
3. Middle name (at will) _____________ 4. Floor ______________________
5. Birth date "____" _______________ 20 _____ years
6. Birthplace: Republic ____________________________________
__________________________________________ area
city (settlement) ___________________________________
area ____________________________________________
7. The number of the been born children: __________________________________
8. Mark about live birth or about the birth of the dead child _________
9. Data on the document confirming the fact of the birth of the child
__________________________________________________________________
10. Legal address: Republic __________________________________
_________________________________________ area
city (settlement) __________________________________
район___________________________________________
Information about the father 11. Surname ____________________________ 12. Name ____________________________ 13. Middle name (in case of its availability) ___________ 14. Birth date "___" ________ ___. 15. Age: __________________ |
Information about mother ______________________________ ______________________________ ______________________________ "____" __________ ___. ______________________________ |
16. Permanent residence:
Republic _______________________________ __________________________________ area city (settlement) ___________________________ area ___________________________________ street ___________________________________ house _____________________________________ apartment _________________________________ |
Republic _______________________________ __________________________________ area city (settlement) ___________________________ area ___________________________________ street ___________________________________ house _____________________________________ apartment _________________________________ |
17. Legal address:
Republic _______________________________ __________________________________ area city (settlement) ___________________________ area ___________________________________ street ___________________________________ house _____________________________________ apartment _________________________________ |
Republic _______________________________ __________________________________ area city (settlement) ___________________________ area ___________________________________ street ___________________________________ house _____________________________________ apartment _________________________________ |
18. Nationality of ___________________ _______________________
19. Income source
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The document ceased to be valid since April 9, 2015 according to the Order of the Government of the Republic of Kazakhstan on March 27, 2015 No. 161