Name Change Affadavit

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marriage license with wedding and engagement ringsIf a shareholder has changed his/her legal name due to marriage, adoption, divorce or any other form of legal action, an Affidavit of Name Change must be submitted to update his/her legal name. It is important that a shareholder's name of record with Goldbelt match their social security number on file with the Internal Revenue Service. Mismatched name and social security number combos could be placed on back‐up withholding by the IRS.


  • Only a shareholder, power of attorney, legal guardian, or custodian of a minor, can change the shareholder’s name.
  • The Affidavit of Name Change must be completed, signed, and dated.
  • The Affidavit must be submitted with a Marriage Certificate, Court Order, Divorce Decree, Social Security Card, or a Government Issued or State Identification Card (w/ their name change).
  • Goldbelt will only accept requests in writing that are supported with one of the previously stated documents.