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Change of Name Form (Individual)

    Change of Name Form (Individual)

    A separate form must be completed for each individual.
    The personal information requested on this form is being collected by Council to maintain an accurate Name and Address Register. The personal information will be used solely by Council for that primary purpose or directly related purposes. The applicant understands that the personal information provided is for Council records and that they may apply to Council for access and or amendment of their information.

    Your Current Details with Council


    Your New Name


    Supporting Documents

    You must supply copies of legal documentation before Council will alter their records.
    Please select which documentation is supporting this application: * (required)


    Accounts with Council



    I have completed all required sections on this form. I declare that all the information provided on this form is true and correct and understand that it is an offence to provide false or misleading information. * (required)
    I acknowledge Wellington Shire Council's Privacy Statement. * (required)

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