Change of Name Form 26
GOVERNMENT OF THE VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR NOTARIES PUBLIC DIVISION Notaries Public Division | Change of Name Form | Revised 4/2026 NOTARY PUBLIC CHANGE OF NAME FORM For commissioned notaries whose legal name has changed Purpose: Use this form to notify the Notaries Public Division of a legal name change and to request that your notary commission records be updated. 1. COMMISSION AND CONTACT INFORMATION Current Commissioned Name Commission Number Physical Address Mailing Address (if different) Telephone Number Email Address 2. NEW LEGAL NAME First Name Middle Name Last Name 3. APPLICANT DECLARATION I, ________________________________________, declare under penalty of perjury that my legal name has changed and that, from this date forward, I will be known as ________________________________________. ☐ I affirm that this request is not made for any fraudulent, misleading, or otherwise improper purpose. ☐ I affirm that I am not seeking this change to evade debts, legal proceedings, or criminal charges. …
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GOVERNMENT OF THE VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR NOTARIES PUBLIC DIVISION Notaries Public Division | Change of Name Form | Revised 4/2026 NOTARY PUBLIC CHANGE OF NAME FORM For commissioned notaries whose legal name has changed Purpose: Use this form to notify the Notaries Public Division of a legal name change and to request that your notary commission records be updated. 1. COMMISSION AND CONTACT INFORMATION Current Commissioned Name Commission Number Physical Address Mailing Address (if different) Telephone Number Email Address 2. NEW LEGAL NAME First Name Middle Name Last Name 3. APPLICANT DECLARATION I, ________________________________________, declare under penalty of perjury that my legal name has changed and that, from this date forward, I will be known as ________________________________________. ☐ I affirm that this request is not made for any fraudulent, misleading, or otherwise improper purpose. ☐ I affirm that I am not seeking this change to evade debts, legal proceedings, or criminal charges. ☐ I understand that the name on my notary commission, bond, seal, ink stamp, and notarial records must be consistent after approval of this request. GOVERNMENT OF THE VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR NOTARIES PUBLIC DIVISION Notaries Public Division | Change of Name Form | Revised 4/2026 NOTARY PUBLIC CHANGE OF NAME FORM Supporting documentation, signature, and notarial certificate 4. BASIS FOR NAME CHANGE Select the reason that best describes your legal name change: ☐ Marriage ☐ Divorce ☐ Court order ☐ Other: __________________________ 5. SUPPORTING DOCUMENTATION Attach a copy of the document that verifies your legal name change. Check the document submitted: ☐ Certified Marriage Certificate ☐ Divorce Decree ☐ Court Order ☐ Updated government-issued identification ☐ Other: __________________________________________________________ Important: Do not submit original legal documents unless specifically requested by the Notaries Public Division. 6. APPLICANT CERTIFICATION AND SIGNATURE I certify that the information provided on this form and in the accompanying documents is true and correct to the best of my knowledge. Applicant Signature Date Printed Name 7. NOTARIAL CERTIFICATE IN WITNESS WHEREOF, I, the undersigned Notary Public, certify that the above-named individual personally appeared before me, was satisfactorily identified as the person whose name is subscribed to this instrument, and acknowledged that ______executed the same for the purpose therein contained. Signature of Notary Public _______________________________________ Printed Name ___________________________ Notary Public Commission Number________________________________ Commission Expiration Date_______________ GOVERNMENT OF THE VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR NOTARIES PUBLIC DIVISION Notaries Public Division | Change of Name Form | Revised 4/2026 GENERAL STEPS FOR A NOTARY NAME CHANGE Keep this page for your records Before you begin: Complete your legal name change with the Social Security Administration and the Bureau of Motor Vehicles, as applicable. Obtain certified or official documentation of the change. 1 Notify the Notaries Public Division. Submit notice within 30 days of your legal name change. 2 Complete this form. Provide your current commissioned name, new legal name, contact information, declaration, and signature. 3 Attach supporting documentation. Include a copy of the legal document verifying the name change and any identification requested by the Division. 4 Submit the required materials. Send or deliver the completed form and attachments to the Office of the Lieutenant Governor, Notaries Public Division. 5 Await approval before replacing supplies. After approval, obtain a new emboss seal, blue ink stamp, notarial certificates, and notary bond that match your updated commissioned name exactly. 6 Submit a new Oath and Seal Form. Complete this required step for final approval of your updated commission. 7 Begin using your updated commissioned name. Use the new name and approved notarial instruments for all future notarizations after the process is complete. IMPORTANT COMPLIANCE REMINDER Do not perform notarizations using a name, emboss seal, ink stamp, or bond that does not match your active commission records. Documents may be rejected, and noncompliance may affect your commission. OFFICE OF THE LIEUTENANT GOVERNOR Notaries Public Division 5049 Kongens Gade • St. Thomas, U.S. Virgin Islands 00802