This Affidavit of Marriage for Name Change is prepared to verify the change of name following the marriage of [YOUR NAME] to Pearl Bergna and to support the name-change process across official and legal documents.

I. Personal Information

I, [YOUR NAME], am of legal age and a citizen of USA. I was married to Pearl Bergna on July 15, 2050, in Fort Wayne, IN 46801. This affidavit is made to confirm the marriage and the subsequent name change requested in accordance with applicable laws and regulations.

Affiant's Information:

Spouse's Information:

II. Marriage Details

The marriage took place on July 15, 2050, at Fort Wayne, IN 46801. The marriage certificate is registered under certificate number FWI-2050-487 in the official records.

As a result of this marriage, I request the adoption of my spouse’s last name, Pearl Bergna, as my new last name. The change will be reflected in all my official documents, including but not limited to my social security records, government-issued identification, and financial records.

III. Name Change Request

In accordance with my marriage to Pearl Bergna, I request to have my name legally changed. My new name will be                               , effective immediately following the filing and processing of this affidavit with the appropriate authorities.

This affidavit will be used to update my name in various government agencies, including but not limited to:

• Social Security Administration

• Department of Motor Vehicles (DMV)

• Financial Institutions

• Employers and Payroll Records

IV. Conclusion

By signing below, I confirm the truth of the information provided in this affidavit and authorize the relevant agencies and authorities to process the name change request in accordance with the law. This affidavit is executed on this July 15, 2050.

Affiant's Signature:

[YOUR NAME]

Date Signed: July 15, 2050

Notary Public:

Signed and sworn before me this July 15, 2050.

Dayton Rohan
My commission expires: July 15, 2055

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