Name Change Deed

DEED OF CHANGE OF NAME I, [old_name], residing at [address], do hereby declare and make known to all whom it may concern as follows: 1. That I have absolutely renounced, relinquished, and abandoned the use of my former name [old_name] and have assumed, in place thereof, the name [new_name]. 2. That I shall hereafter, upon all occasions, be known, called, and described by the name [new_name] exclusively, and not by my former name. 3. [reason] 4. That I authorize and request all persons to designate and address me by my new name of [new_name] accordingly. IN WITNESS WHEREOF I have executed this Deed on [execution_date]. [new_name] (formerly [old_name]) WITNESS 1 WITNESS 2 Name: Name: Address: Address: