Fillable APPLICATION FOR CHANGE OF NAME (Camosun College)

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APPLICATION FOR CHANGE OF NAME (Camosun College)

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The APPLICATION FOR CHANGE OF NAME (Camosun College) form is 16 pages long and contains:

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  • 43 check-boxes
  • 196 other fields

Country of origin: CANADA
File type: PDF

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Page 1 of 10VSA 529 2021/08/13
Then ll out...
Part 1A (pg 5) and Part 1B (pg 6).
Fees section (pg 3).
Search Application (pg 4) only if missing a B.C. birth or marriage document.
Part 1A (pg 5) and Part 1B (pg 6) with your information - not your child’s.
Part 2A and 2B (pg 7-8). Complete a separate Part 2A and 2B for each child
included in the change of name application.
Pages 9 and 10 (if you are requesting a waiver of parental consent).
Fees section (pg 3).
Search Application (pg 4) only if missing a B.C. birth or marriage document.
Part 1A (pg 5) and Part 1B (pg 6) with your information - not your child’s.
Part 2A and 2B (pg 7-8). Complete a separate Part 2A and 2B for each child
included in the change of name application.
Pages 9 and 10 (if you are requesting a waiver of parental consent).
Fees section (pg 3).
Search Application (pg 4) only if missing a B.C. birth document.
ALL required
documentation is submitted. A legal change of name takes at least 4 to 6 weeks to process. Applications submitted with

ELIGIBILITY - Eligible applicants are:
1. Age 19 or older. Note - If you are under 19 but are a parent with custody of your child, you may apply to change your name or that
of your child, without consent from your parent(s).
2. Changing their own name, or are a parent changing the name of their minor child(ren) (18 years of age or younger).
3. Currently living in B.C. and have done so for at least three months immediately prior to the date of application.
COMPLETING THIS FORM

black or blue ink only. Applications completed with pencil will not be accepted. If you are including more than one child in your
application, photocopy or print additional copies of applicable pages in Part 2.
If you are...
An adult (19 years of age or older) changing your name
only
A parent changing BOTH your name AND the name of
your child(ren) who is/are 18 years of age or younger
A parent and are NOT changing your own name, but
ARE changing the name of your child(ren) who is/are
18 years of age or younger
APPLICATION FOR CHANGE OF NAME
UNDER THE PROVISIONS OF THE BRITISH COLUMBIA NAME ACT
How to Fill Out the Application for Change of Name
Newly married? You do not need to complete a legal change of name to use your spouse’s surname (last name).
Section 3 of the Name Act
legal document that provides proof of your right to assume your spouse’s surname.
Are there situations when I should legally change my surname after marriage?
• 



u
v
How do I get a certied copy of a document?
Take the original document to an authorized person listed in step x on page 3. The authorized person will photocopy the original, then certify that it
is a copy of the original document by stamping and signing it. (For a fee of $17, the Vital Statistics Vancouver oce located at 250-605 Robson
Street will witness your signature on the statutory declaration and certify any original documents that are required to be submitted with your
application.)

.
COVID-19 NOTE: Many fingerprinting agencies have now reopened. However, BEFORE BEGINNING your change of name application, contact your local RCMP/Police department
or accredited fingerprinting agency to ask if these services are available.
Page 2 of 10
VSA 529 2021/08/13
w
Who Can Apply as a Parent?

Consent of the Other Parent/Guardian(s) When Changing the Name of Children 18 Years of Age and Younger
If the other parent/guardian(s) will not or cannot provide consent, you must request that Vital Statistics waive their consent. Review Obtaining a Waiver of
Parental Consent on pages 9 and 10 for information about requesting a waiver.
Important Information for Parents Changing the Name of Children (18 or Younger)
SUPPORTING DOCUMENTS
Submit ALL the supporting documentation that applies to your situation.
 
If you are a parent changing the name of your child(ren)... Submit…
And the child(ren) was/were born in Canada
All originalwith a registration number and showing
parentage.
And the child(ren) was/were born outside of Canada
Certied copies of the following:
BOTH sides of each child's MOST RECENTLY ISSUED Permanent

showing
parentage. 
English.
Have documents that are not in English Certied English translation of the documents.


Documentation showing how you came to have your current name. (i.e.

And you are married A photocopy
Have changed the name of your child(ren) before All original 
For each child 12 to 18 years of age
A letter handwritten in ink by your child(ren) providing his/her reasons for
wanting a change of name. Have each child sign and date his/her letter. Each
child 12-18 must also sign in Part 2A - Child's Consent.
All parents
A photocopy of picture ID (e.g. driver's licence) for all parents listed on each
child's birth registration showing their current addresses. The applicant's
address must match the residential address on Part 1A (page 5).
If you are an adult changing your own name and you... Submit...
Were born in Canada All original
Were born outside of Canada
Certied copies of BOTH sides of your MOST RECENTLY ISSUED Permanent

Have changed your name before All original 
Got married in British Columbia (not applicable if divorced or widowed)
All original 
exact proposed
name. NOTE - We CANNOT accept commemorative certicates, marriage
licences, or certicates issued by a church.
Got married in another Canadian province (not including B.C.)
A photocopy
surname on a document submitted or written on your application.
Got married outside of Canada
A photocopy
surname on a document submitted or written on your application.
For all adult applicants
A photocopy of the receipt provided by the official who took your fingerprints
electronically. The date on the receipt must be within 30 days of the
date your application is received in our office.
A photocopy of your picture ID.
Page 3 of 10VSA 529 2021/08/13
x
STATUTORY DECLARATION
Sign the statutory declaration(s) in front of one of the authorized persons listed below:
• Individual appointed by the Attorney General as a commissioner for taking affidavits
• Practicing lawyer or articled law student
• Notary public
Note
at 250-605 Robson Street will witness your signature on the statutory declaration and certify any original documents that are required to
be submitted with your application.)
All applicants must sign the statutory declaration on page 6 at the same time as it is certified.
Dates signed must match. Any parent applicant using the statutory declaration on page 9 must also sign at the same time that
it is certified. 
FINGERPRINTING
Anyone who is BOTH 18 years of age or older AND
check - Name Act (RSBC 1996 c. 328). PARENTS - If you are changing the name of your child(ren) only and not your own name, you
do NOT
Where can I have my electronic ngerprints taken?
• Most RCMP detachments
• Vancouver Police
• Victoria Police
• 
record checks. For a list of accredited companies, visit: http://www.rcmp.gc.ca/en/where-do-get-a-criminal-record-check.
What do I submit with my Change of Name Application?

receipt for your payment. Include a photocopy of the original receipt given with your application.
Important Notes
Fingerprints are only used for the purpose required by the Name Act
returned to the applicant directly from the RCMP.
Do NOT send Vital Statistics a copy of your ngerprints or criminal record check results.
The date on the receipt must be within 30 days of the date your application is received .
PAYMENT & FEES
Submit payment for your application in Canadian funds using the table below to calculate the amount owed. Fees below do not include
the cost of obtaining certified copies or translations, having your signature witnessed on a statutory declaration, or replacing documents
following the change of name.
z
y
Payment Method:
Certified Cheque (No personal or postdated cheques) Money Order Visa MasterCard 
Card holder signature
Interac/Cash payment may be made in person at any Service BC
Vancouver

or money order, make payable to the Minister of Finance
.
PRINT card holder name as shown on credit card
Amount
Enclosed:
Credit Card #

SUBMIT YOUR APPLICATION
Place all documentation and the completed application into a suitably-sized envelope and submit it with payment in person at a
(Visit http://www.servicebc.gov.bc.caor by mail to the address below:
Vital Statistics Agency
ATTN: CONFIDENTIAL SERVICES

Victoria BC V8W 9P3
Applications missing information or documentation are held for 90 days. If you do not respond to a request for information within 90 days,

Adult (19 years of age or older)
$137 Name Change Fee
Adult (19 years of age or older) with dependent child (18 years old or younger)
$137 Name Change Fee
$ 27 For each child
Child only (18 years of age or younger)

$ 27 For each additional child
Birth Search (Fill out application on page 4.)
Marriage Search (Fill out application on page 4.)
$ 27 For each search (B.C. events only)
$ 27 For each search (B.C. events only)
{
Note: Credit card information is not retained. Upon authorization of the
payment request, all credit card information is destroyed.
X
$
NOTE: Applications and payment may also be submitted at the Vital Statistics Vancouver

Print
Reset Page
COVID-19 NOTE: Many fingerprinting agencies have now reopened.
However, BEFORE BEGINNING your change of name application,
contact your local RCMP/Police department or accredited fingerprinting
agency to ask if these services are available.
Page 4 of 10
VSA 529 2021/08/13
What happens to documents submitted with your application?
Document Returned Not Returned

Destroyed

Destroyed

aStamped with "Historical Document. Not to be accepted as proof of current legal name."

a
copies of immigration papers)

General Information
• Vital Statistics will send a Certicate of Change of Name
in your foundation identity document, and your new name. If you have included your child(ren) in your application, their names will also be

• 


NOTE 
• If you were married in Canada, your name change may 

• 

After your change of name application has been processed:
Search Applications for Birth or Marriage Events that Occurred in British Columbia

if the birth and/or marriage occurred in British Columbia
Include
$27 for each search requested when you are submitting your application.
Spouse's Birthplace (City, Province/State, Country)
Month
(e.g. Feb)
Day Year
City/Town/Village
BRITISH
COLUMBIA
Province
Please search for the following MARRIAGE event that occurred in British Columbia:
Date of
Marriage
Place of
Marriage
Provide your SPOUSE'S information below:
If you need Vital Statistics to search BIRTH events for several people in a family (e.g. Mom, plus one or more children), photocopy or print
additional copies of this page. A search application must be completed for each person requiring a search for a BIRTH event.
MOTHER/
PARENT INFO
FATHER/
PARENT INFO
Full name of person named in birth event, as listed at time of birth or following a previous change of name (NOT a married surname)

BRITISH
COLUMBIA
Date of
Birth
Place of
Birth
Surname (Last Name) First Name Middle Name(s)
Surname (Last Name) First Name Middle Name(s)
Surname (Last Name) a First Name Middle Name(s)
Birthplace (City, Province/State, Country)
Birthplace (City, Province/State, Country)
Please search for the following BIRTH event that occurred in British Columbia:
Spouse's Last Name (at the time of marriage)
Spouse's First Name Spouse's Middle Name(s)
Province
City/Town/Village
Month
(e.g. Feb)
Day Year
This form is fillable. Click in Surname field to begin.
Print
Reset Page
Page 5 of 10VSA 529 2021/08/13
Oce Use Only

Part 1 (A) — Adult or Parent Information
APPLICATION FOR CHANGE OF NAME
PARENTS - Enter your information in Part 1(A) and 1(B) even if you are only changing
your child’s name and not your own. Provide your child’s information in Part 2 (pg 7).
Check this box if you are not changing your name
Marital status
AFS #
REG. #
OFFICE USE ONLY
Spouse's Surname
Province/State, CountryCity/TownMMM DD YYYY
Married
Widowed
Divorced
Never Married
Mail to:
Surname (Last Name) First Name Middle Name(s)
Full name as you would like it to appear following the legal change of name (Leave this line blank if you are not changing your name.)
City/Town Province Postal Code
Contact
Numbers
Phone No. (including area code)
Preferred
Number
Email
Address
Alternate
Contact
Number
Alternate Address Below: (if dierent from above)
Above Address
From
MMM DD YYYY
Name/Organization
City/Town Province/State, Country Postal/ZipCode
most recently issued
PRESENT
To
B.C.
B.C.
Date of birth

Place of Birth
Place(s) of residence for last three months
(ALL elds must be completed)
From
MMM DD YYYY
To
MMM DD YYYY
Personal Health Number (PHN)
City/Town Province Postal Code

Is this application changing your surname to the surname of
your spouse? You MUST check a box below.
Yes. I understand that if I was born in Canada
this will change my name on my birth certificate,
and may change my marriage certificate.
No
Surname (Last Name) First Name Middle Name(s)
Date of Marriage
MMM
;
Place of Marriage (City/Town)
Suite/Apt No. Street No. Street Name
Suite/Apt No. Street No. Street Name
Phone No. (including area code)
Suite/Apt No. Street No. Street Name
Province/State, Country
DD YYYY
Notes
Documentation (Check applicable for each section.)
Proof of
Birth
If born in Canada
Enclosed
$27.00 Search Fee (If you were born in British Columbia and do not have a birth


BOTH sides of your MOST
RECENTLY ISSUED
Permanent Resident Card or
Canadian Citizenship Card/

If born outside of Canada - 
Enclosed
Proof of
Marriage
(not applicable if divorced or widowed). N/A
Original enclosed (If married in B.C.)
Photocopy enclosed (If married outside of B.C, a photocopy may be required to show continuity of
usage of names.)
 exact proposed name.)

complete a Search Application on page 4.)
If you are changing your child’s
surname to that of your spouse,
provide a photocopy of your

Proof of
Electronic
Fingerprinting

years of age or older). N/A
Enclosed - The date on the receipt must be within 30 days of the date your
application is received in our office.
If you are 18 years of age or older,
provide a photocopy of the receipt
for your payment for electronic

Previous
Name Change
Have you previously had a legal change of name in Canada?
No
Yes - The original Canadian change of name certificate(s) is/are enclosed.
Yes - I do NOT have the original Canadian change of name certificate(s).
Returned to you stamped with:
"Historical Document. Not to be
accepted as proof of current legal
name".
May we contact you by email?
YesNo
Print
Reset Page
Page 6 of 10
VSA 529 2021/08/13
Dates must match
I ____________________________________________________ have read the application and to the best of my knowledge, information and belief, the statements made are true
in substance and in fact.
AND


AND

a name other than that name on my application form the Vital Statistics Agency will amend my application to match.
AND


AND
Vital Statistics
Act, .
AND
ath.
Signature of Commissioner for Taking Adavits, Lawyer, Articled Law Student, or Notary Public
(Note - Authorized individuals charge a fee for witnessing your signature.)
Statutory Declaration
Part 1 (B) - Adult or Parent Information
APPLICATION FOR CHANGE OF NAME
This information is collected by the Vital Statistics Agency under section 26(c) of the Freedom of Information and Protection of Privacy Act,Vital Statistics Act for
the release of change of name information. Should you have any questions about the collection of this personal information, please contact:

OFFICIAL
STAMP/SEAL
Signature of Applicant
Day Month Year
Declared before me at
City
in the Province of British Columbia, this day of
Day
Month Year
*
Applicant's full name
Write your INITIALS beside any/all situations that apply to you:
I have included all custodial/guardianship court order(s) for my child(ren) within this application.
The court order(s) included is(are) a nal order OR the court order(s) included is(are) still valid and in eect.
List any future court dates:
I do not have any custodial/guardianship court order(s) for my child(ren).
The other parent was not recorded on the child(ren)'s birth registration(s) and there is no custodial/guardianship court order in place for my child(ren).
The other parent and I are still married and there is no custodial/guardianship court order in place for my child(ren).
The other parent and I were married but no longer live together, and there is no custodial/guardianship court order in place for my child(ren).
The other parent and I were never married and there is no custodial/guardianship court order in place for my child(ren).
OR
*
$
#
*
Only a parent recognized on the child's birth certicate or those being listed on the child's immigration documentation can apply to change a child’s name.
However ALL PARENTS and/or CUSTODIAL GUARDIANS must sign consent to a child’s name change.
Section 1 - To be completed by the applicant parent
Section 2 - To be completed by ALL applicants
!
r I am applying as a single applicant to change my name only. Complete Section 2.
r I am a parent applying for myself and my child(ren)'s name change(s). Complete Sections 1 & 2.
r I am a parent applying on behalf of my child(ren) only. I am not changing my name. Complete Sections 1 & 2.

X
X
Documentation Notes
Oce Use Only
All
Applicants
Photocopy of applicant's picture ID (e.g. driver's licence) showing their current address.
A copy of a recent utility bill in the applicant's name (e.g. BC Hydro bill) is
acceptable proof of the current address if it is not listed on identication.
Photocopy of picture ID is enclosed
The address listed on
the applicant's picture ID
must match the residential
address provided in
Part 1A on page 5.
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Page 7 of 10VSA 529 2021/08/13
Date
MMM
*
YYYYDD
CHILD'S CONSENT - Children 12 to 18 years of age MUST provide: Letter Signature
CONSENT OF SPOUSE OF APPLICANT (Only if Child’s surname is changing to that of the Applicant’s Spouse.)
CONSENT OF OTHER PARENT/GUARDIAN(S)
If the other parent/guardian(s):
• consents to the change of name, they must complete Part 2B - "Other Parent's Consent" on page 8.
• is/are not listed on the birth registration, complete section I below.
• is/are listed on the birth registration but you have a valid reason to waive their consent, complete section II below.
Part 2 (A) - Child’s Information (18 Years of Age or Younger)
APPLICATION FOR CHANGE OF NAME
I request that the consent of the other parent/guardian(s): ____________________________________________________ be waived for the following
reason(s):
Last Name(s) First Name(s)
No other parent is recorded on the birth registration of the child whose name is to be changed.
Applicant’s
Signature
Name (Printed)
I, __________________________________________________________________, am the spouse of the applicant and hereby give my consent for the above-listed child to
change his/her surname to be the same as mine.
Signature of
Applicant’s
Spouse
Surname (Last Name) First Name Middle Name(s)
Province/State and CountryCity/TownMMM DD YYYY
Surname (Last Name) First Name Middle Name(s)
Child’s full name as it will appear following the legal change of name (Names on Part 2A and Part 2B must match exactly.)
most recently issued 
Date of birth

Place of birth
I. Other Parent is Not Listed
II. Request for Waiver (A - E) See pages 9 and 10 for information about reasons for waivers and what to submit with your request.
Applicant
Signature
A
B
C
D
E
X
Signature
of Witness
X
Child born outside of Canada - CERTIFIED COPIES of:
BOTH SIDES of child’s MOST RECENTLY ISSUED Permanent Resident Card or
Canadian
showing parentage

Indicate what identication you have enclosed to prove your child’s parentage
Child born in Canada:
showing parentage
$27.00 Search fee (My child was born in British Columbia but I do not have

*
Dates must match
#
#
I hereby give my consent to change my name as stated in this application
Letter handwritten in ink by child is attached.
Date
MMM YYYYDD
Date
MMM YYYYDD
Date
MMM
*
YYYYDD
Date
MMM
*
YYYYDD
No
Yes - ALL original Canadian change of name certificates are enclosed.(This certificate will be stamped "Historical Document. Not to be accepted as proof of current legal
name" and and will returned to you upon completion of this application.)
Yes - I do NOT have the original Canadian change of name certificate(s).
Has your child previously had a legal change of name in Canada? (Check applicable)
Child’s
Signature
Signature
of Witness
X X
X
Date
MMM
*
YYYYDD
X
*
Dates must match
#
#
The other parent/guardian(s) cannot be located after a reasonable, diligent and adequate search has been conducted as demonstrated by statutory declaration and
A custody or guardianship order is required for this option. Obtain an order prior to making application.

The other parent/guardian(s) is/are unreasonably withholding consent to the change of name. - A custody or guardianship order is required for this option. Obtain an order prior
to making application.
The other parent/guardian(s) is/are mentally disordered, as demonstrated by statutory declaration and supporting evidence. - A custody or guardianship order is required for this
option. Obtain an order prior to making application.
. Unless you can provide a valid custody or guardianship order AND a valid
court ordered restraining order/no contact order between the other parent/guardian(s) and the child(ren) this option does not apply.
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Page 8 of 10
VSA 529 2021/08/13
* Dates must match
Part 2 (B) - Consent of Other Parent/Guardian(s)
APPLICATION FOR CHANGE OF NAME
Signature(s) of Other Parent/Guardian(s)
#
Full name(s) of other parent/guardian(s) as listed on the birth registration of child or within court orders.
City/TownMMM DD YYYY
Child’s full name as it will appear following the legal change of name (Names on Part 2A and Part 2B must match exactly.)
Child's date of birth

Child's place of birth
This information is collected by the Vital Statistics Agency under section 26(c) of the Freedom of Information and Protection of Privacy ActVital Statistics Act for
the release of change of name information. Should you have any questions about the collection of this personal information, please contact:

Anyone can witness the signature of the other parent/guardian(s), but the other parent/guardian(s) and the witness must sign at the
same time. 
Consent of Other Parent/Guardian(s)
Signature of Witness
I have read the information provided on this page and to the best of my
knowledge, information and belief, the statements made are true in substance and in fact.
AND


AND


AND

cancelled under Section 40.1 (1)(h) of the Vital Statistics Act
AND
I understand that by consenting to change the name(s) for my child, I will still remain listed as a parent on my child's birth registration, if I am
currently listed.
Name(s) of Other Parent/Guardian(s)
If more than one child is included in the change of name application, or if there is more than one other parent/guardian, please
photocopy or print additional copies of this page.
#
Date
MMM YYYYDD
Date
MMM YYYYDD
Province/State, Country
Surname (Last Name) First Name Middle Name(s)
Suite/Apt No. City/TownStreet No. Street Name
Province/State, Country Postal/Zip Code
Phone No. (including area code)
Surname (Last Name) First Name Middle Name(s)
Full name, address, and phone number of witness to signature(s) of other parent/guardian(s)
Surname (Last Name)
Province/State, Country
Suite/Apt No.
City/TownStreet No. Street Name
First Name Middle Name(s)
Postal/Zip Code
Phone No. (including area code)
X
X
*
*
Documentation Notes Oce Use Only
Other Parent/
Guardian(s)
Consenting to
Child's Change
of Name
Photocopy of other parent/guardian(s') picture ID (e.g. driver's licence) showing their
current address. A copy of a recent utility bill in the name of the other parent/
guardian(s) (e.g. BC Hydro bill) is acceptable proof of the current address if it is
not listed on identication.
Photocopy of picture ID is enclosed
The address(es) listed on the
picture ID of the other parent/
guardian(s) must match the
residential address provided
above.
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Page 9 of 10VSA 529 2021/08/13

Canada
Evidence Act.
Declared before me at in the
Province of British Columbia, this
Signature of Commissioner for Taking Adavits, Lawyer, Articled Law Student, or Notary Public
(Note - Authorized individuals charge a fee for witnessing your signature.)
OFFICIAL
STAMP/SEAL
}
CANADA:


In the Matter of
This statutory declaration MUST be completed if the applicant is asking for a waiver of consent of the other parent/guardian(s) unless the other parent/
guardian(s) is(are) deceased. See pages 7 and 10 for further details. Your Statutory Declaration must include ALL of the following information:
If you require more space, attach a separate sheet of paper.
1. 

2. When was your last contact with the other parent/guardian(s)?
3. What is the last known contact information you have for the other parent/guardian(s)? (Include full addresses, phone numbers, email addresses, or state that
all contact information is unknown.)
4. Do you receive child support from the other parent/guardian(s)?
5. Are you registered with the Family Maintenance Enforcement Program (FMEP)? If yes, submit a copy of the most recent statement.
6. Outline any reasons why you feel the change of name is in your child(ren)’s best interest.
7. 
dates.
Request to Waive Consent of Other Parent/Guardian(s)
I,
in the Province of British Columbia, do solemnly declare that
1.
2.
3.
4.
5.
6.
7.
of
Applicant's Name City
Statutory Declaration
#
Declarant’s Signature
Day Month Year
* *
Dates must match
*
#
}
IMPORTANT - Select one:
I authorize or I do not authorize the Vital Statistics Agency to use the contact information provided with my application and/or
supporting documentation when contacting the other parent/guardian(s) to seek approval for the application.
X
day of
Day
Month Year
X
}
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Page 10 of 10
VSA 529 2021/08/13
Obtaining a Waiver of Parental/Guardian(s) Consent
Under the British Columbia Name Act
The following is a list of grounds on which a waiver of parental/guardian consent may be approved and the documents required. Choose the one that best
applies to your situation and provide ALL of the requested information. If information cannot be provided, include a letter of explanation.
Statements made in a statutory declaration are considered the equivalent of statements made in a Court of Law and may provide
the basis for action against the applicant if they are proven to be fraudulent.
 
additional information.
This information is collected by the Vital Statistics Agency under section 26(c) of the Freedom of Information and Protection of Privacy Act,
requirements of the Vital Statistics Act for the release of change of name information. Should you have any questions about the collection of this personal information,
please contact:

A)
The other parent/guardian(s) cannot be located after a reasonable, diligent and adequate search has been conducted as demonstrated by the
statutory declaration and supporting evidence maintained in the change of name le.
Custody/guardianship order. Obtain an order from the courts prior to applying to legally change the name(s) of your child(ren).
In your statutory declaration list the full mailing address, phone numbers, email addresses and any other contact information for the parent/
guardian(s) whose consent is(are) to be waived.
If you are unaware of the whereabouts of the other parent/guardian(s):
m AND
m Provide proof of attempted contact or conversation thread regarding the change of name through social media (e.g. Facebook),

In your statutory declaration, you must include ALL of the information listed at the top of page 9, "Statutory Declaration-Request to Waive
Consent of Other Parent/Guardian(s)".
If you are registered with the Family Maintenance Enforcement Program (FMEP), include a copy of your latest statement. If you are not registered
with FMEP, include a statement indicating that you do or do not receive support from the other parent/guardian(s).
Children 12 years of age or older must write a brief letter in their own words describing why they would like their name to be changed. The letter
must be handwritten in ink, and signed and dated by the child.
B)
The other parent/guardian(s) is(are) deceased, proven by a copy of a government-issued death certicate maintained in the change of name
le.

C)
The other parent/guardian(s) is(are) unreasonably withholding their consent.
Custody/guardianship order. Obtain an order from the courts prior to applying to legally change the name(s) of your child(ren).
In your statutory declaration, you must include ALL of the information listed at the top of page 9, "Statutory Declaration-Request to Waive
Consent of Other Parent/Guardian(s)".

If you are registered with the Family Maintenance Enforcement Program (FMEP), include a copy of your latest statement. If you are not registered
with FMEP, include a statement indicating that you do or do not receive support from the other parent.
Children 12 years of age or older must write a brief letter in their own words describing why they would like their name to be changed. The letter
must be handwritten in ink, and signed and dated by the child.
D)
The other parent/guardian(s) is(are) mentally disordered, as demonstrated by statutory declaration and supporting evidence
Custody/guardianship order. Obtain an order from the courts prior to applying to legally change the name(s) of your child(ren).
A letter from a physician/court order stating the person whose consent is to be waived is incapable of understanding what they would be signing.
Children 12 years of age or older must write a brief letter in their own words describing why they would like their name to be changed. The letter
must be handwritten in ink, and signed and dated by the child.
E)
Exceptional circumstances make it unreasonable to seek the consent of the other parent/guardian(s). Unless you can provide a valid court
ordered restraining order/no contact order between the other parent/guardian(s) and the child(ren) this option does not apply.
Custody/guardianship order. Obtain an order from the courts prior to applying to legally change the name(s) of your child(ren)
m OR
m OR
m A letter from the police indicating you would be in danger if you attempted to contact the parent/guardian(s) whose consent is required.
Children 12 years of age or older must write a brief letter in their own words describing why they would like their name to be changed. The letter
must be handwritten in ink, and signed and dated by the child.
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APPLICATION FOR CHANGE OF NAME (Camosun College)

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Completed 14 September 2021

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