Foreign Birth Registration (FBR) Application Form

Foreign Birth Registration (FBR) Application Form

Please fill out all pages carefully to complete your application. If you have any questions please contact us.
Applicants Details

Details of the person whose birth is to be registered
Country of residency*
Applicants full name*

Forename(s)Surname
Has your name changed since your birth certificate?*

YesNo
Full Name as per your civil Birth Certificate (if changed)

Forename(s)Surname
Applicants date of birth*

DayMonthYear
Date
Gender as per civil birth certificate*

MaleFemale
Is age over 18?

YesNo
Current

MonthDayYear
Date
Age
Country of birth*
Place of birth*
Marital status*
Mother's birth surname *
Address*
Mobile number*
Alternative number
Email address*

Grandparent born in Ireland

Details of the grandparent born in Ireland
Grandparent born in Ireland parent full name*

Forename(s)Surname
Has your grandparent born in Ireland name changed since their birth certificate?*

YesNo
Grandparent born in Ireland full name as per Irish citizen parent's civil birth certificate (if changed)

Forename(s)Surname
Grandparent born in Ireland's date of birth*

DayMonthYear
Date
Grandparent born in Ireland's gender as per civil birth certificate*

MaleFemale
Grandparent born in Ireland's county of birth*
Grandparent born in Ireland's marital status*
Grandparent born in Ireland's mother's birth surname *
Did this person ever make a ‘declaration of alienage’ (renouncing Irish citizenship) to the Minister for Justice of Ireland or through any Irish Embassy or Consulate?*

NoYes

Declaration and Authorisation
I, {q3_fullname1}, declare that the information provided in this form is true and correct to the best of my knowledge and belief.

I confirm that I have read and agree to the ÉirePassports Terms & Conditions and Privacy Policy.

I consent to ÉirePassports processing and securely handling my personal information for the purposes of providing passport support services in accordance with applicable privacy laws.
Marketing

I agree to receiving occasional marketing emails, newsletters, and promotional updates from ÉirePassports related to passport services and relevant offers. I understand I can unsubscribe at any time.
By signing below, I confirm that I have read and agree to the declaration above, and that the information I have provided is true and correct.

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Date

DayMonthYear
FBR Total
If you’d like to include your passport as part of a package, you’ll receive a 10% discount .Once your FBR certificate is issued, we’ll process your passport application. All passport packages include:A standard 34-page Irish passport (10-year validity for adults), DHL tracked courier delivery, ÉirePassports service and processing support

Yes - the additional amount will be €220No - I just want the FBR certificate
If you’d like to include your passport as part of a package, you’ll receive a 10% discount .Once your FBR certificate is issued, we’ll process your passport application. All passport packages include:A standard 34-page Irish passport (5-year validity for children), DHL tracked courier delivery, ÉirePassports service and processing support

Yes - the additional amount will be €157No - I just want the FBR certificate
Total Amount

Payment Amount

EUR

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please verify that you are human*
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Foreign Birth Registration (FBR) Application Form

Applicants Details

Irish Citizen Parent

Grandparent born in Ireland

Declaration and Authorisation