(REPLACE ALL THE RED TEXT WITH YOUR INFORMATION)

SAME NAME AFFIDAVIT

I, Janice Wright, born on June 27th, 1993 in the town of Georgetown, Province of Ontario, Canada,

SOLEMNLY DECLARE AS FOLLOWS:

• My full legal name as it appears on my Passport is: Janice Barbara Wright.
• My other name is: Janice Barbara Needham.
• I hereby declare that my other name is different due to the fact that I married in 2004 and took my husband's family name.
• I hereby affirm and declare that Janice Barbara Wright and Janice Barbara Needham, all refer to myself, and are one and the same person, and any documents submitted under these names belong to me.

I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath.

Signature:
                                                      

SOLEMNLY DECLARED BEFORE ME at the City of Toronto, Ontario, on:
                                .

Commissioner of Oaths for Ontario
Toronto-Notary-Public.com