Deed Poll Template
DEED POLL ON CHANGE OF NAME
THIS CHANGE OF NAME DEED made this DAY DATE of MONTH YEAR
BY me the undersigned NEW NAME in full of ADDRESS EXCLUDING COUNTY AND POSTCODE in the County of COUNTY now or lately known as OLD NAME in full a British citizen under section 37(1) of the British Nationality Act 1981
Notwithstanding the decision of Mr Justice Vaisey in Re: Parrott, Cox v Parrott, the applicant desires the enrolment to proceed
WITNESSES AND IT IS HEREBY DECLARED as follows:-
1. I absolutely and entirely renounce relinquish and abandon the use of my said former name of OLD NAME in full and assume adopt and determine to take and use from the date hereof the name of NEW NAME in full in substitution for my former name of OLD NAME in full,
2. I shall at all times hereafter in all records deeds documents and other writings and in all actions and proceedings as well as in all dealings and transactions and on all occasions whatsoever use and subscribe the said name of NEW NAME in full as my name in subsitution for my former name of OLD NAME in full so relinquished as aforesaid to the intent that I may hereafter be called known or distinguished not by the former name of OLD NAME in full but by NEW NAME in full only,
3. I authorise and require all persons at all times to designate describe and address me by the adopted name of NEW NAME in full.
IN WITNESS whereof I have hereunto subscribed my adopted and substituted name of NEW NAME in full and also my said former name of OLD NAME in full and have affixed my seal the day and year first above written.
SIGNED AS A DEED
by the above-named
NEW NAME in full NEW SIGNATURE
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formerly known as
OLD NAME in full OLD SIGNATURE
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in the presence of
FIRST WITNESS’S SIGNATURE
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FIRST WITNESS’S NAME AND ADDRESS
SECOND WITNESS’S SIGNAUTRE
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SECOND WITNESS’S NAME AND ADDRESS