Affidavit for Change in Name (Deed Poll) (Sworn Affidavit)

A deed poll is a legal document binding only to a single person or several persons acting jointly to express an active intention. It is, strictly speaking, not a contract because it binds only one party and expresses an intention instead of a promise. (Wikipedia)

A deed of change of name is a legal document used for an official name change by a person. It is one use of a deed poll.

A sworn affidavit is a written statement of facts, voluntarily made and signed by the affiant or deponent and sworn to be true under oath or affirmation administered before a notary public or magistrate or a person having the power to witness an oath and authorised to do so.

A person wanting to change his or her name or surname in the official records (Government prescribed identity documents), will have to submit different kinds of documents to the authorities to effect the name change. One of such documents is a Deed Poll or Sworn Affidavit. Format of which is given hereunder. Alternatively, you may check with the concerned Government authority at first to know if there is any prescribed format for it.

(The affidavit is to be printed on a non-judicial stamp paper of minimum value prescribed in that State and signed by the person who is changing the name, two witnesses and the notary public/magistrate.)

TEMPLATE

DEED POLL AFFIDAVIT

By this deed I, the undersigned _________________ (New name) previously called _________________ (Old name), a _________ (Occupation) and resident of _________________ solemnly declare and affirm as follows:

1. That, for and on behalf of myself, I wholly renounce/relinquish and abandon the use of my former name/surname of _________________ (Old name) and in place thereof, I do hereby assume from this date the name/surname _________________ (New name), so that I may hereafter be called, known and distinguished not by my former name/surname, but assumed name/surname of _________________ (New name).

2. That for the purpose of evidencing such my determination declare that I shall at all times hereafter in all records, deeds and writings and in all proceedings, dealings and transactions, private as well as upon all occasions whatsoever, use and sign the name of _________________ (New name) as my name/surname in place and in substitution of my former name/surname.

3. That I expressly authorize and request all persons in general and relatives and friends in particular, at all times hereafter to designate and address me by such assumed name/surname of _________________ (New name).

4. In witness whereof I have hereunto subscribed my former name/surname of _________________ (Old name) and adopted name/surname of _________________ (New name) and hereunder affix my signature, this __th day of (month), (year).

Signed sealed and delivered by the above name

Date: __________

Place: __________

                                                     Signature of Deponent

                                                     Former name: ____________

In the presence of:

   (witness #1 signature)                  (witness #2 signature)

Name: _____________                Name: ______________

Address: ____________               Address: ____________