Application To Insert Name [Section 15(2)(A)] Into The Birth Certificate For Child Under Age 21 (Peninsular)

Application to insert the name of a child aged one (1) year to less than 21 years who was registered without a name at birth.

Application to insert the name for a child under age 21 may be submitted by the following persons:

1. Birth Certificate Owner
2. The child’s biological mother or father.
3. Legal guardian (attached with child custody authorization letter from JKM).

Applicants are required to appear at the nearest NRD throughout Peninsular Malaysia.

1. Form JPN.LM21 (original).
2. Child’s Birth Certificate (original).
3. Parents’ and parents’ Identity Cards (original and copy).
4. Parents’ Declaration Form (AM80) (original).
5. Family Information Form (BMK81) (original).
6. Parents’ Marriage Document – ​​if any.

Application fee: RM50.00

1. JPN.LM21 – Application for Name Entry/Correction of Information.
2. AM 80 – Declaration Form
3. BMK 81 – Family Information Form

Note: The form in this portal is for guidance only. Please use the original form when submitting your application.