Example Deed Poll
DEED POLL ON CHANGE OF NAME
THIS CHANGE OF NAME DEED made this Sunday 25th of July 2010
BY me the undersigned Joseph Bloggs in full of 13 Alphabet Street, Pretend Road, in the County of Hampshire now or lately known as Josephine Bloggs 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 Josephine Bloggs in full and assume adopt and determine to take and use from the date hereof the name of Joseph Bloggs in full in substitution for my former name of Josephine Bloggs 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 Joseph Bloggd in full as my name in subsitution for my former name of Josephine Bloggs in full so relinquished as aforesaid to the intent that I may hereafter be called known or distinguished not by the former name of Josephine Bloggs in full but by Joseph Bloggs in full only,
3. I authorise and require all persons at all times to designate describe and address me by the adopted name of Joseph Bloggs in full.
IN WITNESS whereof I have hereunto subscribed my adopted and substituted name of Joseph Bloggs in full and also my said former name of Josephine Bloggs in full and have set my hand the day and year first above written.
SIGNED AS A DEED
by the above-named
Joseph Bloggs in full
JBLOGGS
………………………………….
formerly known as
Josephine Bloggs in full
JBloggs
………………………………….
in the presence of
JSmith
………………………………….
John Smith
1 Yellow Brick Road
Oz
Jane Smith
………………………………….
1 Yellow Brick Road
Oz