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CHANGE OF NAME DEED Intended For Enrolling in The Central Office of The Senior Courts of England and Wales

This deed poll document is for changing one's legal name. It contains fields for the applicant to provide their new name in full, address, old name, status (single, married, etc.), and nationality. It declares that the applicant renounces and abandons their old name and will henceforth be known by their new name. They authorize all persons to refer to them by their new name going forward. The document is signed by the applicant under both their new and old names and witnessed.

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Fiona Crooks
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260 views2 pages

CHANGE OF NAME DEED Intended For Enrolling in The Central Office of The Senior Courts of England and Wales

This deed poll document is for changing one's legal name. It contains fields for the applicant to provide their new name in full, address, old name, status (single, married, etc.), and nationality. It declares that the applicant renounces and abandons their old name and will henceforth be known by their new name. They authorize all persons to refer to them by their new name going forward. The document is signed by the applicant under both their new and old names and witnessed.

Uploaded by

Fiona Crooks
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Deed poll LOC020

05.15

CHANGE OF NAME DEED intended for enrolling in the


Central Office of the Senior Courts of England and Wales

Date the deed is made D D / M M / Y Y Y Y

Your new name in full

Your address

Your old name

Status Single Married/Civil Partnership

Widowed Divorced/Civil Partnership dissolved

British Citizen British Dependent Territories Citizen

Commonwealth Citizen

Under section of the British Nationality Act 1981

WITNESSES AND IT IS on behalf of myself


HEREBY DECLARED

I ABSOLUTELY and entirely renounce relinquish and abandon the use of my old name and assume adopt and
determine to take and use from the date of this Deed my new name in substitution for my old name.

I SHALL at all times from this date in all records documents and other writings and in all actions and
proceedings as well as in all dealings and transactions and on all occasions use my new name in
substitution for my old name. I
and my wife and my husband

and my civil partner and my children

and I alone
may after this be called known or distinguished not by the old name but by the new name.

I AUTHORISE and require all persons at all times to designate and address me by my adopted new name.

continued over the page


IN WITNESS I have subscribed my adopted and substituted
“Notwithstanding the forename(s) surname(s)
decision of Mr Justice
Vaisey in Re: Parrott, Cox of (NEW NAME)
v Parrott, the applicant
desires the enrolment to
proceed”
and also my said old
forename(s) surname(s)

of (OLD NAME)

the day and first year above written.

Signed as a Deed and delivered (NEW NAME SIGNATURE)

By the above named


(NEW NAME)

Formerly known as
(OLD NAME) (OLD NAME SIGNATURE)

In the presence of
WITNESS WITNESS
Name Name

Signature Signature

Address Address

Occupation Occupation

LOC020 (05.15)

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