Service Guarantee Refund Form - Online Request

Each field marked by an asterisk (*) must be completed.
The applicant is the individual who requested a certificate and completed the application online.

Applicant Information




Service Level

Which service level appears on your payment receipt? *

Type of Certificate Requested

Select the type of certificate you would like to request for refund. * Birth   Death   Marriage

NOTE: You may only apply for one type of certificate refund at a time.

Collection of Personal Information

Personal information entered on this form is collected under the authority of the Vital Statistics Act, R.S.O. 1990, c. V.4, as amended, and may be used to verify the information provided, your entitlement to the service requested and for law enforcement purposes, as applicable. For questions regarding the collection of your personal information, contact the Office of the Registrar General.

P.O. Box 4600
Thunder Bay, Ontario
P7B 6L8

Greater Toronto Area: 416-325-8305
Toll-free: 1-800-461-2156

I have read the above statement and consent to the disposal of my personal information following the completion of my online request for certificate refund. *