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Name Change Affidavit Format and Gazette Templates
For the Gazette of India, the Department of Publication asks for a signed undertaking, not a notarised affidavit, along with a typed specimen proforma, a CD certificate and a request letter. A notarised affidavit is still useful, because banks and other offices often ask for one. It’s compulsory in one case: adopting a surname different from your father’s or mother’s needs an affidavit attested by a First Class Magistrate.
Which document do you need?
| Document | Needed for the Central Gazette? | Signed by |
|---|---|---|
| Undertaking | Yes (Central Government employees may give a deed instead) | You |
| Specimen proforma | Yes, two typed copies | You, in your old name, plus two witnesses |
| CD certificate | Yes | You |
| Request letter | Yes | You |
| Notarised affidavit | Not for a standard adult case. A First Class Magistrate-attested affidavit is required for a different or added surname. | You, attested by a notary or magistrate |
Fill in everything in [brackets], type the final version on a computer, and use exactly the same names and spellings in every document and in your newspaper notice.
1. Undertaking for gazette name change (adult)
The adult guideline lists what the undertaking must contain (your old and new name, father’s or husband’s name, residential address and a declaration that the facts are true) but doesn’t give a fixed format. This version covers each point.
Undertaking · our format
UNDERTAKING
I, [Old Name], son / daughter / wife of [Father's or Husband's Name], residing at [Full Residential Address with PIN], do hereby undertake and declare as follows:
1. That I have changed my name from [Old Name] to [New Name], and shall hereafter be known as [New Name].
2. That I have published this change of name in [Newspaper Name, Edition] dated [Date].
3. That the facts stated above are true and correct to the best of my knowledge and belief.
Place: [City]
Date: [DD/MM/YYYY]
Signature: ____________________
([Old Name])
2. Specimen proforma for an adult (official)
This is the Department of Publication’s specimen wording. It is the text that gets printed in the Gazette. Submit two computer-typed copies, sign in your existing old name, and have both witnesses fill in their details.
Specimen for change of name (major) · Official
I hitherto known as [Old Name] son / daughter / wife of [Father's or Husband's Name], employed as [Your Post] in the [Office or Company Name], residing at [Residential Address], have changed my name and shall hereafter be known as [New Name].
It is certified that I have complied with other legal requirements in this connection.
[Old Name]
Signature (in existing old name)
Witness No. 1
Full Name: ______________ Signature: ______________
Address: _____________________________________
Mobile: ______________
Witness No. 2
Full Name: ______________ Signature: ______________
Address: _____________________________________
Mobile: ______________
The specimen asks for your post and employer. If you aren’t employed, settle that wording before you type the final copies, because it must match your newspaper notice and CD.
3. Specimen proforma for a minor (official)
Specimen form for change of name of minor · Official
I [Parent's Name] son of / wife of [Name], employed as [Post] in the [Office or Company Name], residing at [Residential Address], have changed the name of my minor son / daughter [Child's Old Name] aged [Age in years] and he / she shall hereafter be known as [Child's New Name].
It is certified that I have complied with other legal requirements in this connection.
Signature of Guardian
Witness No. 1
Signature: ______________ Full Name: ______________
Address: _____________________________________
Mobile: ______________
Witness No. 2
Signature: ______________ Full Name: ______________
Address: _____________________________________
Mobile: ______________
4. What goes on the CD
The CD holds the proforma text in an MS Word file (.doc or .docx), without the witness portion, with your old name typed where the signature goes. No scans, PDFs, signatures, photos or ID details. For an adult it looks like this:
CD text (MS Word) · adult
I hitherto known as [Old Name] son / daughter / wife of [Father's or Husband's Name], employed as [Your Post] in the [Office or Company Name], residing at [Residential Address], have changed my name and shall hereafter be known as [New Name].
It is certified that I have complied with other legal requirements in this connection.
[Old Name]
5. Certificate that the hard copy and CD match
Hard copy / soft copy certificate · our format
CERTIFICATE
I, [Old Name], son / daughter / wife of [Father's or Husband's Name], residing at [Residential Address], certify that the contents of the hard copies of my change-of-name proforma and the soft copy on the enclosed CD are the same. I will be responsible for any mismatch or loss in transit.
Date: [DD/MM/YYYY]
Signature: ____________________
([Old Name])
6. Request letter to the Controller of Publications
Request (forwarding) letter · our format
To
The Controller of Publications
Department of Publication
Civil Lines, Delhi-110054
Subject: Request for publication of change of name in the Gazette of India, Part IV
Sir / Madam,
I request you to publish my change of name from [Old Name] to [New Name] in the weekly Gazette of India, Part IV.
I enclose:
1. Undertaking
2. Original newspaper, [Newspaper Name] dated [Date]
3. Prescribed proforma in duplicate
4. CD containing the proforma in MS Word
5. Certificate that the hard copy and soft copy are the same
6. Two self-attested passport-size photographs
7. Self-attested copy of photo ID ([ID type])
8. Bharatkosh receipt for ₹[Amount], reference [Transaction Ref] dated [Date]
Mobile: [Mobile Number]
Email: [Email]
Yours faithfully,
____________________
([Old Name])
[Full Address with PIN]
7. Name change affidavit (notarised)
Use this for banks, universities and other offices, or when a magistrate-attested affidavit is required. Stamp paper value and attestation rules are set by each state, so check locally before you buy stamp paper. Odisha’s e-Gazette, for example, asks for an affidavit sworn before an Executive Magistrate or Notary Public.
Affidavit for change of name · common format
AFFIDAVIT
I, [Old Name], aged [Age] years, son / daughter / wife of [Father's or Husband's Name], residing at [Full Residential Address with PIN], do hereby solemnly affirm and declare as under:
1. That I am a citizen of India.
2. That my name is recorded as [Old Name] in my [documents, e.g. Class 10 certificate, PAN].
3. That I have changed my name from [Old Name] to [New Name] [optional: reason, e.g. after marriage].
4. That I shall hereafter be known as [New Name] for all purposes.
5. That [Old Name] and [New Name] are the names of one and the same person, namely myself.
DEPONENT
VERIFICATION
Verified at [Place] on [Date] that the contents of the above affidavit are true and correct to the best of my knowledge and belief, and nothing material has been concealed.
DEPONENT
8. Undertaking wording for a name of another religion
If you adopt a name or surname of another religion without converting, the adult guideline requires your undertaking to state that you are not changing your religion. Add this line to the undertaking above:
Extra declaration · from the adult guideline
4. That I confirm that I am not changing my religion.
The Department publishes its own specimen formats for change of religion, adoption of a child, change of name and gender, and a minor’s change of name after divorce. Download them from deptpub.gov.in → Change of Name / Public Notices.
Filling-in rules that prevent rejection
Format FAQs
How do I write an affidavit for a name change?
State your old name, age, father’s or husband’s name and address, then declare that you’ve changed your name, that you’ll be known by the new name, and that both names belong to the same person. End with a verification, and get it attested by a notary or magistrate on stamp paper of the value your state requires.
Do I need an affidavit for a gazette name change?
Not for a standard adult case. The Central Gazette guideline asks for a signed undertaking. An affidavit attested by a First Class Magistrate is required if you adopt a surname different from your father’s or mother’s, or add a surname.
Is an undertaking the same as an affidavit?
No. An undertaking is a signed declaration by you. An affidavit is sworn before a notary or magistrate, usually on stamp paper. The Gazette of India accepts an undertaking for a standard adult change of name.
What stamp paper value do I need for a name change affidavit?
It depends on your state, because stamp duty is set by each state. Check with your local notary or stamp vendor before you buy. The Central Gazette’s standard undertaking doesn’t need stamp paper.
Who signs the gazette proforma?
You sign both copies in your existing old name, and two witnesses add their full name, address, mobile number and signature. For a minor, the father or mother signs as guardian.
Can I change the wording of the specimen proforma?
Keep to the Department’s specimen. The Controller of Publications can reject material that is incomplete, vague or misleading, and the text must match your newspaper notice and CD.
Sources
- Guidelines and specimen for change of name: adult (PDF)
- Guidelines and specimen for change of name: minor (PDF)
- Guideline for adopting a different surname (PDF)
- Odisha e-Gazette: change of name/surname
These templates are general formats for reference, not legal advice.
More gazette name change guides
Gazette name change fees
Official ₹1,100 / ₹1,700 rates, Bharatkosh payment steps and the full cost.
Documents required
The official 7-document checklist plus extra papers for your situation.
Name change after marriage
When a marriage certificate is enough, and when you need the gazette.
Minor name change
How a parent changes a child’s name: ₹1,700 fee, documents and records.
The full process
The 6 steps of a gazette name change, from undertaking to download.
Get your gazette file right the first time
Send us your details on WhatsApp. We’ll tell you exactly which documents and fee apply to you, then prepare the file for you to sign and post.