Name Change Affidavit

Affidavit of Name Change

I, ______, of the city of ______ in the Province/State of ______, DO SWEAR AND STATE:

1. I was born on ______ in ______.

2. I am a citizen of ______ .

3. My permanent address is ______.

4. The purpose of this affidavit is to provide evidence of my correct, current legal name.

5. My current legal name is ______.

6. I was previously known as: ______.

7. For greater clarity, ______ and ______ are one and the same person.

8. I make this affidavit for submission to ______ and for no other unlawful and/or improper purpose.