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1. Title and Declaration Statement: Formal title of the affidavit and opening declaration statement including the deponent's current full legal name and address
2. Personal Information: Current personal details including date of birth, place of birth, current residential address, and contact information
3. Birth Certificate Details: Current birth certificate information including registration number, place of registration, and date of registration
4. Requested Name Change: Clear statement of the current name and the proposed new name, including spelling and full format
5. Reasons for Name Change: Detailed explanation of the grounds and reasons for requesting the name change
6. Previous Name Changes: Declaration regarding any previous name changes or attempts to change name
7. Supporting Documents: List of all supporting documents attached to the affidavit
8. Declaration of Truth: Formal statement declaring that all information provided is true and correct
9. Signature Block: Space for deponent's signature, date, and notary/authority attestation
1. Consent of Other Parent: Required when the name change involves a minor and both parents have parental authority
2. Medical/Professional Evidence: Required when name change is requested due to medical or professional reasons
3. Criminal Record Declaration: Statement regarding absence of criminal record, required in some jurisdictions
4. Translator's Declaration: Required when any supporting documents are not in Dutch or English
1. Appendix A - Identity Documents: Copies of current valid ID documents (passport, Dutch ID card, or residence permit)
2. Appendix B - Current Birth Certificate: Certified copy of the current birth certificate to be modified
3. Appendix C - Supporting Evidence: Documentation supporting the reasons for name change (medical certificates, professional documents, etc.)
4. Appendix D - Proof of Address: Recent proof of residence in the Netherlands
5. Appendix E - Payment Confirmation: Proof of payment of required administrative fees for name change application
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