SAMPLE NAME AFFIDAVIT I James Robert Smith hereby declare that I have been known by the follo

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SAMPLE NAME AFFIDAVIT I James Robert Smith hereby declare that I have been known by the follo Powered By Docstoc
					                                     SAMPLE
                                      NAME AFFIDAVIT


I, ____James Robert Smith____________________ hereby declare that I have been known by
the following names or nicknames over the course of my lifetime:

James Robert Smith                      Jim Robert Smith
James R. Smith                          Jim R. Smith
James Smith                             Jim Smith

I hereby certify that I am one and the same person who is identified by each of the names listed
above.


____________________________                 ___________________________
Adoptive Father’s Signature                           Date




I, __Susan Marie Smith_______________________ hereby declare that I have been known by
the following names or nicknames over the course of my lifetime:

Susan Marie Smith          (married name*)    Susan Marie Davis (maiden name*)
Susan M. Smith                                Susan M. Davis
Susan Smith                                   Susan Davis
Sue Marie Smith                               Sue Marie Davis
Sue M. Smith                                  Sue M. Davis
Sue Smith                                     Sue Davis

* No need to type what is in italics. This is for informational purposes on this sample only.

I hereby certify that I am one and the same person who is identified by each of the names listed
above.


________________________________                 ___________________________
Adoptive Mother’s Signature                                Date


County of                        }
State of                         }

Sworn to and subscribed before me on this _______day of _________________ 20___.



                                                     ________________________________
                                                                 Notary Public
European Adoption Consultants
GD-102

				
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Description: Free Affidavit Sample document sample