Please complete all sections of this form and attach a copy of the documentary evidence proving the year of birth.
The evidence can be:
- Birth Certificate (preferred)
- A Statutory Declaration stating the year of birth
- A copy of a passport or driver’s licence
Please note that you will not be able to submit the application if evidence is not attached. Applications should be sent to the Protocol Unit no less than two (2) months and no more than six (6) months prior to the date of the birthday. Applications received with less than two (2) months notice will be processed but cannot be guaranteed to arrive by the date of the birthday.
Applications later than one month after the birthday cannot be submitted.
The Protocol Unit process messages to be sent by the Premier of South Australia as well as advises the offices of Her Majesty The Queen, the Governor-General, the Governor, Prime Minister, Federal and State Leaders of the Opposition, and Federal and State Members of Parliaments for 90th, 95th, 100th, 105th and 110th Birthdays.
Please note that messages are not sent from Her Majesty to persons who are not citizens of a Commonwealth country.
If you would like to arrange a 90th Birthday Message from the Prime Minister of Australia please contact your Federal MP’s office.
The Protocol Unit can only process applications for recipients who are residents of South Australia. Please contact the relevant state Department of the Premier for recipients residing in other states.