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Sample Affidavit for Name Change After Marriage

In some cases, women change their names to adopt their spouse's last name after marriage and most of the documents contain the maiden name. If you apply for any visa or change of status in the U.S. with your new name, you must show an affidavit stating that the name mentioned in the following documents (attach the list of documents) and your current name refers to the same person. The sample shown below is a template for the Affidavit for the Name Change after Marriage.

(Please type this Affidavit after carefully reading the notes mentioned below the format)


I, _____________________________________ daughter of ___________________________ and wife of ______________________________ aged _________, residing at _____________________________________________________________________________, do hereby solemnly affirm and declare as Under:

1. That my maiden name is __________________________________________________.
2. That I got married to [name of the husband] on [date of marriage] at [place of marriage].
3. After marriage my name is ________________________________________ and all the records have the same name.
4. I have not obtained the marriage certificate.
5. I state that [maiden name] and the [present name] is the name of one and the same person and that is myself.

I am executing this declaration to be submitted to the concerned authorities for the change of name.
I hereby state that whatever is stated herein above are true to the best of my Knowledge.


____[Signature of Deponent]______                        ________Date_________

(Affix Passport Size Joint Photograph with spouse below)


Verification of a Statement on Oath or Affirmation

State of _____________________________________________

County of ___________________________________________

Subscribed and Sworn to (affirmed) before me this _______   day of ________    , 20_______

by ____________________________ (name(s) of individual(s) making statement, personally appeared before me in __[insert state]_____________, proved to me on the basis of satisfactory evidence to be the person(s) whose name is subscribed to the within Affidavit and acknowledged to me that he/she executed the same in his/her authorized authority, and who being first duly sworn on oath according to law, deposes and says that he/she has read the foregoing Affidavit subscribed by him/her, and that the matters stated herein are true to the best of his/her information, knowledge, and belief.

I certify under PENALTY OF PERJURY under the laws of the state of _________________ that foregoing paragraph is true and correct.

1. The affidavit has to be sworn before a Notary Public.

2.The joint photograph of the couple should be pasted on the affidavit and attested by the Notary Public with his/her signature and rubber stamps

3. The affidavit is required when a passport is issued the first time with the married name of a woman applicant.

4.The affidavit is required the first time, when the names of the spouses are to be endorsed in their respective passports.

The sample documents provided here are for informational purposes only and to be utilized at the user’s discretion. These act as a guide only and the content within these are to be customized as per requirement. While Lawbench covers general guidelines, it does not guarantee access to visas or ensure entry into the United States of America or assure any other form of privileges. Lawbench and its affiliates are not responsible for any losses or damages that may arise from having used these sample documents.