APPLICATION FOR CHANGE OF NAME OF A MINOR

(To complete all sections in BLOCK LETTERS)

To: The Honourable Attorney General

The Humble Petition of minor:
Surname: …………………………………………………………………………………
Name(s): …………………………………………………………………………………
Date of birth: …………………………………………………………………………………
Sex: …………………………………………………………………………………
BY THE RESPONSIBLE PARTIES:-
PARENTS: Surname…………………………………………………………………….……...……..
Name(s)……………………………………………………………………….…………..
Surname……………………………………………………….…………..….…………..
Name(s)……………………………………………………………………….…………..
Telephone: ……………………………………… Mobile:………………………………………..
Email (if applicable): ……………………………………………………………………………..
National Identity Card No.
National Identity Card No.

CHANGE OF SURNAME TO: …………………………………………………………………………….

CHANGE OF NAME TO: ……………………………………………………………………………

I/ We, the responsible party/parties of the minor of (Address)

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Respectfully state that:
1. I/We am/are the responsible party/parties of the petitioner in the present matter.
2. The Petitioners and/or the Minor are Mauritian Citizens.
3. I/We am/are petitioning for leave from Honourable Attorney-General to change the:-
NAME

SURNAME

for the following reason(s): - (good and sufficient grounds to be explained)

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4. I/We pray accordingly.

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Signature/ Thumbprint of Responsible

Party/Parties of Minor

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Full names of person(s) signing or affixing thumbprint

Date:………………………………………………………………………..

NB: A copy of the Minor’s birth certificate and the parents’ birth and marriage certificates and
National identity cards (if applicable) or any other proof of identity should be enclosed with the
present petition.