Change your name on the JP register

1. Complete the form

   1. Are you recognised as any of the below? *

      • Justice of the Peace (Qualified)
      • Commissioner for Declarations
      • Justice of the Peace (Magistrates Court)
      • Justice of the Peace (Commissioner for Declarations)
      • Justice of the Peace
      • None of the above

   2. (If you chose ‘None of the above’ above)

      To use this form you must be a Justice of the Peace or a Commissioner for Declarations.

What is your registration number? *
1. What is your name as it currently appears on the JP register? *
2. What is your new name? *
3. What is the reason for your name change? *

   • Marriage
   • Separation / Divorce
   • Other

4. (If you chose ‘Marriage’ above)

   Please provide a copy of your marriage certificate.

5. (If you chose ‘Separation / Divorce’ above)

   Please provide a copy of either your marriage certificate or birth certificate.

6. (If you chose ‘Other’ above)

   Please provide a copy of either a deed poll or a change of name certificate from the Registry of Births, Deaths and Marriages.

* Upload and attach a file Approved file types are .doc .docx .pdf .odf .jpg .jpeg .bmp .tif .tiff .png .xls .xlsx

Your file has been attached. We will receive it when you submit this form.
Contact details
1. What is your preferred contact number? *

   • Home phone
   • Mobile phone
   • Work phone
Home phone *
Mobile phone
Work phone
Mobile phone *
Home phone
Work phone
Work phone *
Home phone
Mobile phone
2. Email * Example: jane.smart@example.com
3. Residential address

   1. Address line 1 *
   2. Address line 2
   3. 1. Town, city or suburb *
      2. State *
      3. Postcode *
4. Is your postal address the same as your residential address? *

   • Yes
   • No
5. (If you chose ‘No’ above)

   1. Postal address

      1. Address line 1 *
      2. Address line 2
      3. 1. Town, city or suburb *
         2. State *
         3. Postcode *
Acknowledgement
• Acknowledgement

  All details are true and correct.
•  
• Acknowledgement

  I have read and agree to the privacy statement. View the privacy statement.