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	CHANGE OF NAME
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OTHER AREAS:
	STAFF VACANCIES

Online Change of Name Declaration Form

Please fill in the form below and submit it to send it to us (fields marked with * are required):

Full name NOW*:
Occupation*:
Gender*:	Male: Female:
Address line 1*:
Address line 2:
Town*:
County*:
Country*:
Postcode*:
E-mail address:
Phone number*:
Alternate phone number:
Fax number:
Your new name in full
New name*:
Any previous change of name*?	Yes: No:
Previous name?
Circumstances?
If you are known by your new name:
When did you start to be known by it?
In what circumstances?
Payment
Our usual Cost is £176.25 being £150.00 plus £26.25 VAT BUT A SPECIAL WEB PRICE APPLIES - The price is £58.74 being £49.99 plus £8.75 VAT Method of payment (choose one): 1. Credit card Please telephone 07000 269 252 with credit card details OR 2. Cheque payable to Berkeley Solicitors, please send cheque to: Berkeley Solicitors 100-102 Market Street Droylsden Manchester M43 6DE. Note: Your request will be processed after your payment is received by Berkeley Solicitors.
I will be paying by*:	Credit card: Cheque:
Please send me my change of name documents by*:
E-mail:
Fax:
Post:
Please complete the box below to help us avoid spam:


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