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Aka Affidavit Form
_________________________________________.
(Year)
(Birth Name)
3. I hereby certify that the difference between ______________________________ and
(Birth Name)
__________________________ are the results of my own actions.
(Current Name)
4. I hereby further certify that ___________________________________ and
(Birth Name)
_________________________ are one and the same person.
(Current Name)
_____________________________________
Signature
Subscribed and sworn to
before me this__________
day...
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