Telephone order for an Adult Deed Poll
Payment by debit/credit card or approved account only
Order taken by Enter initials in capital letters.
"Before we proceed, please confirm you can pay with a debit or credit card." "I also need to tell you there is a £4 non-refundable application handling fee [for each deed poll ordered]. Are you happy to proceed?"
Section 1 Applicant's personal details Applicant's current name, new name and address will appear on their Deed Poll document.
*Current title —Please choose an option—MrMrsMissMsMxDrOther
*Current forenames First and any middle names
*Current surname
*Is applicant known by another name (fee £8)
Confirm type Not applicableAlso known as nameFormerly known as nameRegistered at birth name
*New title —Please choose an option—MrMrsMissMsMxDrOther If you change your title, we can incorporate a change of title declaration on your Deed Poll document for which a £4 fee is payable. If an other title is ticked, enter new title in comments box and request faxed documentary evidence of entitlement to use new title. Medical doctors only need tell us their GMC reference number.
*New forenames
*New surname
*Full postal address This should be applicant's permanent residential address. This must be a physical address and not a PO Box address. You can provide a different address for delivery in section 3
Additional Addresses (optional) If the applicant has another address on any documents and records, we can also include this address on the Deed Poll for which an additional fee of £2 is payable No additional addresses
*Age
*Date of birth
*Nationality If the applicant has another address on any documents and records, we can also include this address on the Deed Poll for which an additional fee of £2 is payable
Do you require your Deed Poll dated for a specific future date
Any comments or additional information (optional)
Section 2 Applicant's contact details
*Email address
*Daytime telephone number We will only call you if we have a query with your application.
Best time to call
If we call, whom should we ask for (optional)
If someone else answers the phone can we say who we are if we are asked YesNo If no, we will say the call is private. If you are not available, we will say we will call back later.
Section 3 Delivery service required These prices are per order e.g. two Deed Polls sent by UK Express will cost an extra £10 (not £10 each).
UK Standard: Free We aim to post within four working days by Royal Mail's 1st class mail service. UK Priority: +£4 Posted same day by Royal Mail's 1st class mail service (if application received by 5.30pm Monday to Friday). UK Express: +£10 Posted same day for guaranteed delivery by 1pm next working day (if application received by 5.30pm Monday to Friday). UK Express: (Saturday delivery): +£14 Guaranteed delivery by 1pm Saturday (if application received between 5.30pm Thursday and 5.30pm Friday). UK Express Plus: +£20 Posted same day for guaranteed delivery by 9am next working day (if application received by 5.30pm Monday to Friday). UK Express Plus (Saturday delivery): +£24 Guaranteed delivery by 9am Saturday (if application received between 5.30pm Thursday and 5.30pm Friday). Overseas Standard: +£5 We aim to post within four working days by Royal Mail's Tracked or Signed accelerated air mail service. Overseas Express: +£10 Posted same day by Royal Mail's Tracked or Signed accelerated airmail service (if application received by 5.30pm Monday to Friday). Overseas Express Courier: +£10 +FedEx fees Posted same day using FedEx's International Priority service (if application received by 1pm Monday to Friday). Delivery will be between 1 and 3 working days depending country (next working. day to USA and Canada). Use the link below to see FedEx's fees. *Please select which delivery option you would like: —Please choose an option—StandardPriorityExpressExpress (Saturday delivery)Express plusExpress Plus (Saturday delivery)Overseas StandardOverseas ExpressOverseas Express Courier *To whom should we address the envelope Delivery address
Section 4 Legal copy and archive service "Organisations such as the Passport Office, DVLA, Banks and the Land Registry will not accept a photocopy of your Deed Poll document. Our legal copies will be accepted by these organisations in lieu of your original Deed Poll thus avoiding your original Deed Poll being lost or damaged in the post. Also, we will archive an image of your signed Deed Poll document so you can order further legal copies in the future should you lose or mislay your Deed Poll."
*Are legal copies required Yes, with 2 legal copiesNoYes, with 3 legal copiesYes, with 4 legal copiesYes, with 5 legal copiesYes, with 6 legal copiesYes, with 7 legal copiesYes, with 8 legal copiesYes, with 9 legal copiesYes, with 10 legal copiesYes, with 11 legal copiesYes, with 12 legal copiesYes, with 13 legal copiesYes, with 14 legal copiesYes, with 15 legal copiesYes, with 16 legal copiesYes, with 17 legal copiesYes, with 18 legal copiesYes, with 19 legal copiesYes, with 20 legal copiesYes, with 21 legal copiesYes, with 22 legal copiesYes, with 23 legal copiesYes, with 24 legal copiesYes, with 25 legal copies
The fee for our legal copy and archive service is £13 with legal copies costing £1 each (two minimum).
Section 5 Is this application for a replacement Deed Poll or to provide the applicant with evidence of a past name change to their current name? The fee for this modification is £4.
*Do you require a declaration for a past name change NoYes
If NO then proceed to section 6
The date applicant's name was changed to their current name Please provide at least the year.
How was applicant's name changed —Please choose an option—by Deed Pollby Change of name deedby Statutory declarationby Solicitor's letterby Usageby Using my decree absoluteOther (provide details below)
Any comments or further information
If you require this modification, in section 1 above, please ensure you have entered your former name in the current name boxes and your current name in the new name boxes. Also, the address you enter in section 1 above should be your current address and not where you were living when you previously changed your name.
Section 6 Does the applicant wish to claim a fee reduction for being a previous client If yes, a £10 fee reduction will be given on the total value of the order. * Has the applicant changed their name with us before NoYes If NO then proceed to section 7
The former name (in full) on applicant's previous Deed Poll
The year previous Deed Poll ordered
Now go to section 8
Section 7 Does the applicant wish to claim a fee reduction for receiving a qualifying benefit? A £10 fee reduction is available on the total value of the order if we receive either:
Income Support
Income related Employment & Support Allowance
Pension Credit
Income-based Jobseeker's Allowance
Housing Benefit
Working Tax Credit
Child Tax Credit (if your household income is less than £20,000 per annum)
Universal Credit (if your household income is less than £20,000 per annum)
If someone receives Child Benefit for you
The fee reduction is only available if we receive written evidence of the applicant's benefit entitlement (an original award notice, not a fax or photocopy, dated within the past 3 months). To advise how to obtain a new award notice click on this link (opens pop-up window) for contact details. Please note, this reduction cannot be claimed if claiming the fee reduction as a previous client.
*Claiming a fee reduction for receiving a qualifying benefit NoYes
If paying by debit or credit card and written evidence does not arrive by the time we process the application, we will charge the full fee and enclose a claim form with the Deed Poll documentation, which can be returned to us with written benefit evidence of the benefit for a £10 refund. If paying by PayPal, the full fee needs to be paid but we will enclose a claim form with the Deed Poll documentation, which can be returned to us with written benefit evidence for a £10 refund.
Section 8 Payment method *Payment method Credit/debit cardCharge an account
Name Order number
Card details Applicant's card will not be charged until we prepare their Deed Poll. Card type —Please choose an option—MastercardVisaVisa DebitVisa ElectronMaestroAmerican Express Card number Expiry date Security number The last 3 digits printed on the card's signature strip (4 digits on the front of AmEx cards) Cardholder's name Statement address (If different from your delivery address given in section 1) Cardholder's daytime telephone number If different from your contact number above
Additional applications
Is this application linked to other applications NoYes - AdultYes - Child
Right to cancel. Read the following text to applicant
"Finally, I need to tell you that in accordance with The Consumer Contracts Regulations of 2013, your right to cancel ends when we prepare your Deed Poll documentation, which will be in about X hours/days. So please contact us as soon as possible if you wish to cancel your order and not incur any fee in addition to the £4 application handling fee." [Note: £4 is non-refundable per deed poll]