Change Of Name Deed Poll

I. Parties

Name Change Applicant: [Your Name]
New Name: [Your New Full Name]
Address: [Your Address]
Date of Birth: January 18, 2060

II. Statement of Intent

I, [Your Name], residing at [Your Address], do at this moment declare that I intend to change my name to [Your New Full Name]. This change is made for personal reasons and I plan to use my new name in all future legal and personal matters.

III. Legal Statement

I hereby declare that:

I will assume and use the name [Your New Full Name] from the date of this deed and discontinue using my former name, [Your Name].
All documents, records, and legal instruments will henceforth reflect my new name, [Your New Full Name].
This deed shall be in effect from the date of execution and can be presented as evidence of my name change in all relevant matters.

IV. Acknowledgment and Execution

To formalize this name change, I am executing this deed poll in the presence of a witness.

[Your Name]

[Date of Execution]

V. Witnesses

This Change Of Name Deed Poll is witnessed and signed on the day and the year first above written.

[WITNESS 1 NAME]

[Date of Execution]

[WITNESS 2 NAME]

[Date of Execution]

VI. Declaration

I, the undersigned witness, confirm that I was present when [Your Name] signed this deed poll and that they are known to me or have provided valid identification.

VII. Notice of Legal Change

The applicant should inform all relevant parties, including government agencies, financial institutions, and other organizations, about the change of name. This deed poll serves as legal evidence of the name change.

VIII. Further Instructions

For any subsequent updates or questions, contact the applicant at [Your Email]. Additionally, any necessary legal filings should be made in accordance with applicable laws and regulations.

NOTARIZATION:

State of [STATE], County of [COUNTY]

On this [DATE], before me, a Notary Public in and for said county and state, personally appeared [Your Name] and [WITNESS 1 NAME], known to me to be the persons whose names are subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.

[NOTARY PUBLIC NAME]

Notary Public in and for [STATE]

My Commission Expires: