THIS DEED POLL is Date  23 November 2024 

BY 

(1)NEW_NAME of ADDRESS, formerly known as FORMER_NAME.

BACKGROUND

We have parental responsibility of the individual whose name address and description are respectively set out in the First Schedule hereto D hereby absolutely renounce and abandon the use of his former name as set out in the Second Schedule hereto ( “ Former Name ” ) and in lieu thereof DO assume from the date hereof the name as set out in the First Schedule hereto ( “ Newly Assumed Name ” ).

In pursuant of such a change of name, we declare that at all times hereafter in all records, deeds, proceedings, instruments, transactions and on all occasions use and sign with the new minor's applicants name in place of his former name. We authorise and require any third parties to refer to the minor application and to address him by the new name of his Newly Assumed Name.

 

THE FIRST SCHEDULE

Name :	( “Newly Assumed Name” ) NEW_NAME
Address:	ADDRESS
Identification document:	ID_TYPE no. ID_NO

 

THE SECOND SCHEDULE

( “Former Name” )

  FORMER_NAME

 

     IN WITNESS whereof I have hereunto signed my Newly Assumed Name and have set my hand and seal this 23 November 2024. 

SIGNED as a deed by PARTY_1_NAME and PARTY_2_NAME, and	______________________   _______________
SIGNED SEALED and DELIVERED by the said NEW_NAME formerly known as FORMER_NAME in the presence of	_______________             my Newly Assumed Name     _______________             Specimen signatures of  my Former Name

       

 

 

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