DEED POLL FOR CHANGE IN NAME

This deed of name change is made at……….this day of………by the undersigned Mr…………residing at………single (married or divorced) a citizen of………witnesseth and declares for myself (and my wife and children) as follows;
1. I the undersigned absolutely renounce and abandon the said name including my Christian name and surname (or only my name and only my surname as the case may be) and assume the name of……….from the date of this deed.
2. I shall at all times from now in all records, deeds and instruments in  writing and  in all actions  and  procedure and  in all dealings and transactions and all occasions will use and sign the name of………..as my name instead of my former name of……..which is renounced.
3. I authorize and request all persons to designate and address me (my wife or children) by the assumed name of
In witness whereof 1 have signed my name both the original and the assumed new name in the presence of witness
Witness Sd./………..