Name Change Affidavit Format Sample
I, ———————–S/o———————Daughter of ——————-, aged around ———-years, resident of ——————–, do hereby solemnly affirm and declare as under:
1.That my name as per the records is —————-(XYZ).
2.That I have changed my name as _________ on (date of change of name).
3.At present all the records have my new name _________.
4. I am getting a public notice published to this effect in the newspaper.
5. I state that (earlier name) and the (present name) is the name of one and the same person and that is myself.
I am executing this declaration to be submitted to the concerned authorities for the change of name.
I hereby state that whatever is stated herein above are true to the best of my knowledge.
Solemnly affirmed at ________ )
On this ____ day of ______ 20 ) (Signature of the Applicant).
Deponent
VERIFICATION:
Verified on this day—————–at ———————that the contents of the affidavit are true and correct, nothing material has been concealed and no part of it is false.
Deponent.
See Also – Change of Name complete process and Download Name change affidavit PDF here