Affidavit of Name Change
Date:
I,
of address:
declare under oath that:
1. My former/full name was:
2. I have legally changed my name to:
3. Reason for name change:
I make this affidavit to attest my change of name and for all legal purposes it may serve.
Signature of Affiant
Name:
Notary/Public Officer/Witness Signature
Name: