Form FP 15

APPLICATION ON NOTICE

Family Proceedings Act 1980 - Births, Deaths, And Marriages Act


I, Melanie l'Heuremaudit, apply for an order declaring that the sex listed on my 
Birth Certificate be changed from "Male" to "Female", on the following grounds:

   Declaration of Family Court as to sex, Part V, Section28  -  Births, Deaths, And 
   Marriages Registration (pages 58 - 59.)

I say:

   28 (3) (a) [Melanie l'Heuremaudit] has assumed the gender identity of a person  
              of the nominated sex (female); and

          (b) Has undergone such medical treatment as is usually regarded by 
              medical experts as desirable to enable persons of the genetic/physical 
              confirmation of the applicant at birth to acquire a physical 
              confirmation that accordswith the gender identity of a person of 
              the nominated sex; and

          (c) Will, as a result of the medical treatment undertaken [irreversible 
              surgical gender reassignment from male to female] maintain a gender 
              identity of a person of the nominated sex.

I request the Registrar of the Court to arrange this matter.



Signature of Applicant:



Date:



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