Affirmation For A Name Change - Legal Results LLC

Step 1 of 2

NOTE: Please fill out the below fields that has an *
Address*
State of County of
Present/Current Name of Applicant:
Name*
First Middle Last
Date Current Name was Assumed:
Date*
MM slash DD slash YYYY
Former Name of Applicant Applying:
Name*
First Middle Last
Applicant’s Date of Birth:
Date*
MM slash DD slash YYYY
Number of Years, you have known applicant that is applying*
Current Name (in use)*
First Middle Last
Former Name (not in use)*
First Middle Last
Your Relationship to the Applicant*
The variance in the Applicant’s Name appears on his/her Birth Record and their name is currently used:*
Current name is used exclusively/only for all purposes.
Name*
First Middle Last
Address is*
Address is ZIP / Postal Code
I solemnly swear that the information given above by me is true and correct to the best of my knowledge and belief, that the applicant’s named above has been known by both his/her present, and former names as stated and is one of the same person, that the applicant is known by his or her present name to friends, associates, relatives, and in the community in which he/she is residing.*
Date
MM slash DD slash YYYY
Address*
State of County of
Notary Public*
Title (and Rank)*
My communication expires
Checklist for Affirmation for a Name Change
Documentation Becoming legal
- This affirmation should be signed and dated in front of a notary public by
- After being signed in front of a notary, this document should be delivered to the appropriate court for filing.
Public by*
Copies
- The original affirmation should be filed with the clerk of the court or delivered to the requesting business/employment.
- The affiant/signer should maintain a copy of the affirmation. Your copy should be kept in a safe place. If you signed a paper copy of the document as the affiant/signer, make sure your documentation is safe and secure for future reference.

Name*
First Last
Business Name
Email Address (optional)
Business Address (optional)
Product Name
Total
$0.00
Credit Card*

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Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name