THE UNITED REPUBLIC OF TANZANIA
THE OATHS AND STATUTORY DECLARATIONS ACT,
(CAP 34 R.E, 2002)
AFFIDAVIT OF CHANGE OF NAME
I, JOHNSON YESAYA MGELWA, Adult male, Christian of Sinza Ward, Ubungo District, Dar-es-salaam Region in Tanzania, do hereby affirm and take oath as follows:
1. That, I am a deponent hence conversant with the facts I am about to depose hereunder;
2. That the National Identification Authority mistakenly issued my National Identification Card with names JOHNSON YESAYA MGELA instead of JOHNSON YESAYA MGELWA.
3. That, my actual names are JOHNSON YESAYA MGELWA which appears on my Academic Certificates and other official documents.
4. That, I abandon the names JOHNSON YESAYA MGELA as used by National Identification Authority on the Identification Card No. 12345678910 and I assume my all-time names JOHNSON YESAYA MGELWA.
5. All that I have stated above in paragraphs 1, 2, 3 4, and 5 is true to the best of my knowledge.
AFFIRMED at Dar es Salaam by the said
JOHNSON YESAYA MGELWA
Who is known to me personally ………………………
Introduced to me by
………………………..……… DEPONENT
later known to me personally on this
……... day of ……….… 2024.
BEFORE ME:
Name: ……………………………………..
Qualifications………………………………
Address…………………………………….
Signature: …………………………………..
Date: ……………………………………….
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