Apply for discounted Adult Deed Poll

To change your name, simply complete and submit the application form below. Payment will then be taken via credit or debit card. You should only submit this application if you qualify for our discounted rate. To see if you qualify click here.

You must be at least 16 years of age to complete this application form.

If you need assistance completing this form please call our helpline on 0800 983 0143.

* Denotes a mandatory field

Section 1
Delivery
This is the name and address we will put on the envelope when we post your Deed Poll pack to you. All Deed Poll packs are posted within one working day via first class mail. There is no charge for this delivery service.

Full name:	*

Address:	*



Postcode:	*

Any additional information:

Section 2
Personal
Your current name, new name and address will appear on your Deed Poll document. Your title will only appear on your Deed Poll if you are changing it.

Current title:


Current forenames:	* First name and any middle names.

Current surname:	*

New title:


If you wish to change your title to something other than Mr, Mrs, Miss or Ms then after submitting your application please post us documentary evidence of your entitlement to use your desired title. Click here for our postal address. If we do not receive satisfactory evidence of your entitlement to use your new title or we do not accept your new title, we will proceed with your application but omit your change of title. Therefore, your Deed Poll document will only show your name change.

New forenames:	* If there is no change enter current forenames.

New surname:	* If there is no change enter current surname.

Address:

This is the address that will appear on your Deed Poll document and should be your permanent residential address. You only need to complete this if it is different to the delivery address you provided in Section 1.

Postcode:

Date of birth:	*

Nationality:	*

If you are not British or you are a British national living outside the United Kingdom click on this link to check if you are eligible to apply for a Deed Poll.

Any additional information:

Section 3
Contact
Please fill in your contact information below in case we have a query about your order.

E-mail address:	*

If you would prefer not to be contacted by telephone you can choose to leave the spaces below blank..

Telephone number.:

Name you are known by at this number:

Best time to call:

Section 4
How are you eligible for the discounted rate?
You could be eligible for the discounted rate if you or a member of your household is a previous Deed Poll client or if you are receiving a qualifying benefit. If you are unsure if you qualify please read the page Clients qualifying for the discounted rate before submitting your application. I am eligible as I (or a member of my household) is a previous Deed Poll client: Yes/No If yes please give us the details of any previous Deed Poll applied for so we can find it on our system.

Full former name:

Full new name:

House number:

Postcode:

Date Deed Poll was ordered:	If you are unsure provide your best estimate.

Any comments or additional information:
	I am eligible as I receive a qualifying benefit: Yes/No
If yes please select one of the following benefits you are receiving in the drop down box.

If you apply for our discounted rate based on a qualifying benefit we require you to send us a photocopy of recent written evidence of your benefit entitlement once you have submitted your application. We will not post your Deed Poll pack until we have received such evidence. Proof of your entitlement should be sent to: UK Deed Poll 9 Three Cliffs Swansea SA3 2BN

Section 5
Payment
Payment can be made by credit or debit card click the payment button below to make payment through WorldPay’s secure server.

Please check over your details carefully before submitting your application.