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Certificate request
Constituency Office
Certificate request
Which certificate(s) would you like to request?
The Queen
Anniversary: 60+ or Birthday: 100+
8 weeks notice required (copy of birth or marriage certificate required)
The Governor General
Anniversary: 50th-59th or Birthday: 90+
6-8 weeks notice required
Prime Minister
Anniversary: 25, 30, 40, 45 & 50+ or Birthday: 75+
6 weeks notice required
MP Navdeep Bains
Any special celebration, anniversary or birthday
6 weeks notice required
Contact Information
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Mr.
Mrs.
Ms.
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Address
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Alberta
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Recipient Contact Information
(The person to whom the certificate will be issued)
Recipient Name (As it will appear on the certificate)
Address:
City:
Province:
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code:
Event Details
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Birthday
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Other
Number of years:
Date:
(YYYY/MM/DD)
Date of Celebration:
(YYYY/MM/DD)
(if different from above)
Additional Information
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Confederation Building, Room # 776
House of Commons, Ottawa, ON K1A 0A6
T (613) 995-7784 F (613) 996-9817
6660 Kennedy Road, Suite 215-A
Mississauga, ON L5T 2M9
T (905) 795-5220 F (905) 795-5252