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DEED POLL/SWORN AFFIDAVITBy this deed I, the undersigned _______________________________________________________________________________
_____________________________________________________________________________(given name)(surname)(new name)
etc. now lately called__________________________________________________________________________(old name),doing
___________________________________ ________________________________ (given profession or avocation) and resident of ______________________________________________________________________ do hereby solemnly declare:1. That for and on behalf of myself and my wife and children and remitter issue wholly renounce/relinquish and abandon the
use of my former name/surname of (given name)(surname)___________________________________________________
and in place thereof I do hereby assume from this date the name/surname _________________________________________
and so that I and my wife and my children and remitter issue may hereafter be called, known and distinguished not by my
former name/surname,but assumed name/surname.2. That for the purpose of evidencing such my determination declare that I shall at all times hereafter in all records, deed and
writings and in all proceedings dealings and transactions, private as well and upon all occasions whatsoever use and sign the
name of(given name)(surname)___________________________________________________________________________
name/surname in place and substitution for my former name/surname.3. That I expressly authorize and request all persons in general, relative and friends in particular at all times hereafter to
designate me, my wife, my children, remitter issue by such assumed name/surname of (given name)(surname)___________
4. In witness whereof I have hereunto subscribed my former and adopted name/surname of(given name) __________________
____________________________________________________________________________________________________ office my signature and seal, if any, this ______________________day of_____________________________Signed, sealed, and delivered by the above name(given name)(surname) __________________________________