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Department of Internal Affairs – Te Tari Taiwhenua

BDM403

Application by donor to access information held on the Human Assisted Reproductive Technology Resister

Last updated 24 April 2024

Part 1: Before you start

Use this form if you:
• have donated sperm, eggs or embryos to a fertility service provider for use in assisted reproductive procedures, and 
• want to access information about yourself or people who were born as a result of your donation recorded on the Human Assisted Reproductive Technology (HART) Register. 

How to submit your application
Complete and post to:
HART Team
Births, Deaths and Marriages
PO Box 1052
Wellington 6140 

What you need to provide 
You will need to provide a:
• certified true copy of your photo identity document
• BDM405 Authorisation for disclosure of information to agent form, if the information is being sent to an agent, such as a lawyer, acting on your behalf. 
Your photo identity document can be your driver licence or the photo page from your passport.
A certified true copy is a photocopy that has been stamped or endorsed by an authorised person. This confirms that the copy is a true copy of the original document. 
An authorised person must be:
• a Justice of the Peace (JP)
• a solicitor or notary public (you may have to pay for their services), or
• a Registrar or Deputy Registrar of the District Court or the High Court, or 
• authorised staff in some government agencies.

Services a counsellor can offer
We recommend that you consult with a counsellor of your choice before submitting this form. 
A counsellor can:
• help you to consider the implications of providing and accessing information
• support you if you contact a donor-conceived person, if a link is established
• answer questions about how others have approached the issue, and what seems to work best. 
Counselling may be able to be arranged through your fertility service provider, or with an independent counsellor.

Requested information
If the requested information is available on the HART Register, you will receive a printout of the information you request in section 3 of this form. 
The printout will be typed from the registration. A printout is not a legal document.

Form begins

1. Your details
Current first name(s) ^
Current surname ^
Fertility service provider (and branch) ^
Fertility service provider identifier (if known) ^

2. Delivery address you would like any information sent to
Street number and name ^
Suburb ^
Town or city ^
Country ^
Postcode ^
Contact phone number ^
Email address ^

3. Requested information 
If the birthdate of the donor-conceived person or your donation was before 22 August 2005, there may be no information recorded in the HART register because registrations were not mandatory. Restrictions on disclosure of some types of information may apply.

A printout containing all or any of the following: $40.80
Yes or no, information held by BDM in the HART register relating to you ^
Yes or no, information about all donor-conceived people related to you. Subject to consent to disclosure by donor-conceived person or people. ^

A printout containing the following information: $15.30 
(no fee if you have requested with one of the above products)
Yes or no, whether any donor-conceived people have been born and their gender ^

4. Payment
Charge my credit or debit card (Visa, MasterCard, American Express, Prezzy Card):
Card number ^
Card expiry date ^
Name on card ^
Cardholder signature ^