NAME OF ORGANIZATION
I write to inform you that, for and on behalf of my child CHILDS CURRENT
NAME, I wholly renounce, relinquish and abandon the use of the
aforementioned former name, so that my child will from the date hereof be
called, known and distinguished not by the aforementioned former name of
CHILDS CURRENT NAME but by the chosen assumed name of CHILDS NEW NAME.
I hereby authorise and require all persons at all times hereafter the date
thereof to designate and address my child not by the former name CHILDS
CURRENT NAME but by such chosen assumed name of CHILDS NEW NAME.
I the undersigned, INSERT THE PARENTS NAME THAT IS WRITTEN ON THE DEED,
hereby declare that I share parental responsibility for my son/daughter
with INSERT SECOND PARENTS NAME. I have sought INSERT SECOND PARENTS NAME
permission and she/he has provided a signature below, thus indicating
his/her approval to proceed with the Deed of Change of Name.
You will find enclosed herewith the original Deed Poll which was signed and
sealed on Sunday, 30 January 2011.
I trust the information contained herein is sufficient in order to enable
you to amend your records accordingly; moreover, after you have checked for
the visible watermark – you may wish to contact Simon Browne, Compliance
Manager, The Legal Deed Service Ltd on 0845 519 0968 should you wish to
verify the authenticity of this Deed of Change of Name (DEED POLL).
MOTHERS SIGNATURE FATHERS SIGNATURE
PARENTS NAME (MOTHER) | PARENTS NAME (FATHER)