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Change of Name For Minors (Under 21 Years Old) : (Select One)
Change of Name For Minors (Under 21 Years Old) : (Select One)
Child’s/Ward’s Child’s/Ward’s
original name amended name
Child’s/Ward’s Child’s/Ward’s
original ethnic amended ethnic
name name
1
B. I declare that…
(select one)
☐ the other parent/ legal guardian(s) is aware of this application and has
consented to change the minor’s particulars as requested at Section A.
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*Delete as necessary
I affirm that the minor has no other parent/ legal guardian(s) other than the above named.
For the avoidance of doubt, “legal guardian” includes any testamentary guardian
(appointed pursuant to s7 of the Guardianship of Infants Act) and any person who has
been appointed by a court as such, or has been granted custody of the minor under an
Order of Court.
I declare that all information submitted in this application is true, accurate and complete
to the best of my knowledge and belief. I understand that, if I have concealed relevant
information or provided false, inaccurate or misleading information, I may be prosecuted
for offences under the Immigration Act, Passports Act, and/or Penal Code. Any facilities,
rights or privileges granted under this application may also be withdrawn.
________________________ ______________
Signature of Declarant Date