Affidavit of Name Change I am currently listed in the by legalstuff1

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									                                           Affidavit of Name Change


     I am currently listed in the shareholder records of Bristol Bay Native Corporation and the village of

                                                                                         under the name of
                           (name of village corporation)

                                                  My social security number is:
             (previous name)                                                                     (social security number)

      Because of marriage or other legal action                                                                                    ,
                                                                                 (describe legal action)
my name has been changed to                                                                                     .
                                                                    (new name)


                                                           Dated this _____ day of __________________, 200_____.

                                                           Signature: _______________________________________

                                                           Printed Name: ___________________________________


  Subscribed and sworn to before me, this _____ day of ________________________________, 200 _____.




                                                             U. S. Postmaster or Notary Public
                                                             in and for the state of:
                                                             My Commission Expires:

                                                                                                                    Revised 2/1/2002

								
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