I, __________, __________ __________, aged __________ years, resident of __________, Aadhaar No. __________, do hereby solemnly affirm and declare as under:
That my name as recorded in my existing documents and records is __________.
That I have given up the name __________ and have adopted, and shall hereafter be known by, the name __________ for all purposes.
That the reason for this change of name is __________.
That __________ and __________ are one and the same person, that this change of name is made voluntarily and out of my own free will, and that it is not made for any fraudulent purpose and not to evade any legal obligation or to defraud or cause loss to any person.
That I undertake to use the name __________ in all my future dealings, documents and correspondence, and that I shall have the following records, currently in the name __________, corrected and updated accordingly: __________.
That I have no objection to this change of name being published in the Gazette of India or in any newspaper, and that I shall be bound by the name __________ from the date of this affidavit onward.
That this affidavit is made for general and lawful use, including production before any bank, employer, educational institution, government department or other authority that requires proof of this change of name.
VERIFICATION
Verified at __________ on this __________ that the contents of the above affidavit are true and correct to the best of my knowledge and belief, and that nothing material has been concealed therefrom.
DEPONENT __________
Signature: ______________________________
Sworn/Affirmed before me this __________ at __________, the deponent having been identified to my satisfaction.
NOTARY PUBLIC / OATH COMMISSIONER Name: ______________________________ Registration No.: ______________________________ Seal and Signature: ______________________________
AFFIDAVIT FOR CHANGE OF NAME
I, __________, __________ __________, aged __________ years, resident of __________, Aadhaar No. __________, do hereby solemnly affirm and declare as under:
That my name as recorded in my existing documents and records is __________.
That I have given up the name __________ and have adopted, and shall hereafter be known by, the name __________ for all purposes.
That the reason for this change of name is __________.
That __________ and __________ are one and the same person, that this change of name is made voluntarily and out of my own free will, and that it is not made for any fraudulent purpose and not to evade any legal obligation or to defraud or cause loss to any person.
That I undertake to use the name __________ in all my future dealings, documents and correspondence, and that I shall have the following records, currently in the name __________, corrected and updated accordingly: __________.
That I have no objection to this change of name being published in the Gazette of India or in any newspaper, and that I shall be bound by the name __________ from the date of this affidavit onward.
That this affidavit is made for general and lawful use, including production before any bank, employer, educational institution, government department or other authority that requires proof of this change of name.
VERIFICATION
Verified at __________ on this __________ that the contents of the above affidavit are true and correct to the best of my knowledge and belief, and that nothing material has been concealed therefrom.
DEPONENT __________
Signature: ______________________________
Sworn/Affirmed before me this __________ at __________, the deponent having been identified to my satisfaction.
NOTARY PUBLIC / OATH COMMISSIONER Name: ______________________________ Registration No.: ______________________________ Seal and Signature: ______________________________