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1. Personal Information: Full identification details of the declarant including current full name, date and place of birth, nationality, and current address
2. Current Name Declaration: Details of the current legal name, including how and when it was acquired (birth, previous change, marriage, etc.)
3. Requested Name Change: Clear statement of the new name being requested, with proper spelling and full details
4. Reasons for Change: Detailed explanation of the motivation for the name change request
5. Legal Declaration: Formal statement confirming the truth of all provided information and understanding of legal implications
6. Prior Name Changes: Declaration of any previous name changes, if any, including dates and jurisdictions
7. Criminal Record Statement: Declaration regarding presence or absence of criminal record
8. Signature Block: Space for declarant's signature, date, and place of signing
1. Parental Consent: Required if the declarant is a minor, including consent statements and signatures from both parents or legal guardians
2. Spouse Notification: Required if the declarant is married, acknowledging that the spouse has been informed of the name change
3. Professional Status: Required for certain professions where name change might have regulatory implications
4. Children's Information: Required if the name change affects minor children, including their details and any relevant custody information
5. Translation Certificate: Required if any supporting documents are not in French, Dutch, or German
1. Appendix A - Identity Documents: Copies of current valid ID, birth certificate, and proof of address
2. Appendix B - Supporting Evidence: Documentation supporting the reasons for name change (e.g., professional, personal, or cultural reasons)
3. Appendix C - Criminal Record Check: Official extract from criminal records or police clearance certificate
4. Appendix D - Publication Notices: Copies of any required public notices or announcements of the intended name change
5. Appendix E - Additional Certificates: Marriage certificate, divorce decree, or other relevant legal status documents
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