deregistratio

1. Pleasetakenoticeoftheinstructionsforfillingouttheform!
Thefollowinginformationsarerequiredsubjecttosect. 13,15,17and18oftheRegistrationLaws.
APPLICATIONforderegistration-
Dateofmove/relocation
Day
Month
Year
Gemeindeschlüssel
Gemeindeschlüssel
Dailystampoftheregistryoffice
New residence (street/place, number, floor)
(ZIP/Postal code) (ZIP/Postal code, town/community; if in a foreign country incl. country
Previous residence (street/place, number, floor)
The previous residence in Germany was
Other residence in Germany (street/place, number, floor)
Pos. Surname/last name Earlier names/maiden name/name of birth First name(s)
1
2
3
4
Pos. Academic title Gender Place of birth (county, state, province, country)
1
2
3
4
Marital status Date of birth
Pos. Nationality(ies) Date and place of marriage/civil partnership
1
2
3
4
Religion
Legal representative (first name, surname, academic title, date of birth, address)
Place, date
Applicant'ssignature
09.1.62.000
ZIP/Postal code) (town, community)
This residence is:
This residence is:
Personwhohaveadditionalordifferentmainorsecondresidenceshavetofilloutanownapplication
Legal status of the registered children
to the father to the mother
Ifyouaremovinginaforeigncountry,youhavetoderegisteryourself.
IfatthesametimeyougiveuponeorseveralresidencesinGermanyandyoudon'tmoveintoanewresidenceinGermanyyouhavetoderegistertheresidenceyougiveup.Youcandoitatanyregistryofficeyouareactuallyregistered.
Inthesecasesthefilledoutandsignedapplicationhastobesubmittedinstantlyattheconcernedregistryoffice.
PleaseprinttheGermanformbelow!
Other residence in Germany (street/place, number, floor)
ZIP/Postal code) (town, community)
(town, community)
Regardingyourightstoprotestagainstthetransferofprivateinformationincertaincases,pleasereadattachedapplicationintructions.
theonlyresidence
mainresidence
secondresidence
mainresidence
secondresidence
mainresidence
secondresidence
M
F
M
F
M
F
M
F
Check andprintGermanversion Clear
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