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Name Change Affidavit Template
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Name Change Affidavit Template
This Name Change Affidavit (the “Affidavit”) is made on [Date] by:
Affiant: [Full Name], date of birth: [DOB] (optional), address: [Address], phone/email: [Contact].
1. Current and Former Name
1.1 Former Legal Name: [Old Full Name]
1.2 Current Legal Name: [New Full Name]
1.3 Date Name Change Took Effect: [Date]
2. Basis for Name Change (Select One)
2.1 ☐ Court order (attach copy)
2.2 ☐ Marriage (attach marriage certificate)
2.3 ☐ Divorce (attach decree)
2.4 ☐ Adoption (attach order)
2.5 ☐ Other legal basis: [Explain + attach proof]
3. Purpose of This Affidavit
3.1 I am making this Affidavit to request that my records be updated with: ☐ bank ☐ employer ☐ school ☐ insurer ☐ government agency ☐ other: [List].
4. Identification and Supporting Documents
4.1 The following documents are attached or available upon request:
☐ Court order/certificate
☐ Marriage certificate
☐ Divorce decree
☐ Updated government ID
☐ Social Security/Tax ID update confirmation (if applicable)
☐ Other: [List]
5. Statement Under Oath
5.1 I declare under penalty of perjury that the statements in this Affidavit are true and correct to the best of my knowledge.
Signatures
Affiant: [Full Name]
Date: [Date]
Signature: ___________________________
Witnesses (If Required)
Witness Name: [Name]
Date: [Date]
Signature: ___________________________
Notary / Notarization (If Required)
State of [State]
County of [County]
On [Date], before me, [Notary Name], personally appeared [Affiant Full Name], known to me (or satisfactorily proven) to be the person whose name is subscribed to this Affidavit, and acknowledged that they executed it for the purposes stated.
Notary Public Signature: _______________________
My Commission Expires: _______________________
Notary Seal (if applicable): ___________________
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Name Change Affidavit Template
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For quick answers, scroll below to see the FAQ.
Click below for detailed info on the template.
For quick answers, scroll below to see the FAQ.
NAME CHANGE AFFIDAVIT TEMPLATE FAQ
What is a name change affidavit?
A Name Change Affidavit is a sworn statement confirming that a person has changed their name and is requesting updates to records. It can be used to support updates with banks, employers, schools, insurers, or other organizations, especially when an agency requests an affidavit in addition to a court order or certificate.
Does this replace a court order?
Usually no. Many jurisdictions require a court order for a legal name change (except in cases like marriage/divorce where documents may be sufficient). This affidavit can support record updates but does not itself grant a legal name change.
What information should be included?
Include: prior legal name, new legal name, date/effective date of name change, reason (optional), and a list of documents attached (court order, marriage certificate, divorce decree, updated ID). This template includes each of these in a simple format.
Do you need notarization?
Often yes. Notarization is commonly required for affidavits used for official records. This template includes notarization and an optional witness section.
Can this be used after marriage or divorce?
Yes. Many people update names after marriage or divorce. This template includes an option to state the basis for the change.
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