Deed Poll for Name Change

I. Introduction

This Deed Poll is made on the [Date] by [Old Name] of [Current Address], hereinafter referred to as the "Declarant."

II. Declaration

The Declarant hereby expressly and absolutely renounces and abandons the use of their former name and adopts the new name, [New Name], for all purposes and intends upon all occasions to be known solely and exclusively by this adopted name.

III. Statement of Intent

From the date of this Deed Poll, the Declarant will only use the new name for all official, personal, and legal matters. The Declarant declares that the change of name is not for any fraudulent purpose.

IV. Implementation

The Declarant requests that all persons address them only by their new name and that all records, official documents, and identifications be updated to reflect this change.

V. Notification

The Declarant shall notify the following parties of their change of name:

• Government Agencies

• Employer

• Bank and Financial Institutions

• Medical Providers

• Utility Companies

• Friends and Family

VI. Governing Law

This Deed Poll shall be governed, construed, and enforced in accordance with the laws of [Applicable Jurisdiction].

VII. Signature

I hereby execute this Deed Poll and confirm its contents to be true:

Signed by [Your Name]:

Declarant

Witness 1:

Name: Toby Sherwood

Address: Stafford, VA 22554

Witness 2:

Name: Pat Foley

Address: Stafford, VA 22554

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