Fillable Deed Poll/sworn Affidavit Form printable pdf download

DEED POLL/SWORN AFFIDAVIT

By this deed I, the undersigned _______________________________________________________________________________

_____________________________________________________________________________(given name)(surname)(new name)

etc. now lately called__________________________________________________________________________(old name),doing

___________________________________

________________________________

(given profession or avocation) and resident of

______________________________________________________________________ do hereby solemnly declare:

1. That for and on behalf of myself and my wife and children and remitter issue wholly renounce/relinquish and abandon the

use of my former name/surname of (given name)(surname)___________________________________________________

______________________________________________________________________________________________________

and in place thereof I do hereby assume from this date the name/surname _________________________________________

and so that I and my wife and my children and remitter issue may hereafter be called, known and distinguished not by my

former name/surname,but assumed name/surname.

2. That for the purpose of evidencing such my determination declare that I shall at all times hereafter in all records, deed and

writings and in all proceedings dealings and transactions, private as well and upon all occasions whatsoever use and sign the

name of(given name)(surname)___________________________________________________________________________

________________________________________________________________________________________________as my

name/surname in place and substitution for my former name/surname.

3. That I expressly authorize and request all persons in general, relative and friends in particular at all times hereafter to

designate me, my wife, my children, remitter issue by such assumed name/surname of (given name)(surname)___________

__________________________________________________________________________________________ accordingly.

4. In witness whereof I have hereunto subscribed my former and adopted name/surname of(given name) __________________

____________________________________________________________________________________________________

and(surname)__________________________________________________________________________________________

office my signature and seal, if any, this ______________________day of_____________________________

Signed, sealed, and delivered by the above name(given name)(surname) __________________________________

_____________________________________________________________________________________________

formerly _______________________________________________________________________ in the presence of

Name _________________________________________________________________________________

Address _______________________________________________________________________________

Name _________________________________________________________________________________

Address _______________________________________________________________________________

(This deed poll/affidavit may be signed and attested in presence of a Notary Public)

Deed Poll/sworn Affidavit Form