Home Tuition - Change of Name Form (AF-SNTG17)
Published date | 23 October 2019 |
Issuer | Department of Education |
AF-SNTG17 1 Last Updated: 30/10/2018
CHANGE OF NAME REQUEST FORM
The completed claim form should be submitted to:
Home Tuition Payments Section, Schools Division Financial, Department of Education and Skills,
Cornamaddy, Athlone, Co. Westmeath, N37 X 659
Important: This Department can only maintain one name for each individual.
Current details held by this Department.
Name: ____________________________________ PPSN: ________________________________
Date of Birth: __________________________
I, the undersigned, wish to inform the Department of Education & Skills that I have now changed my name to the
following:
Name: __________________________________________________
With effect from: _________________________________________
Reason for name change:
Marriage: Please forward original or certified copy of legal Marriage Certificate
Deed Poll: Please forward original or certified copy of your registered deed poll
Other Reason: Please forward any and all supporting documentation.
Please Specify: ___________________________________________________________
Signature: _________________________________________ Date: ________________
Data Protection Privacy Statement
The Department of Education and Skills, as far as practicable and having regard to the resources available, provides
for education and training for people resident in the State at a level appropriate to meet the needs and abilities of
those people. The main purpose for which the Department requires the personal data provided by you is to affect
your change of name and to support the accounting process the payment of this grant and the accounting and
auditing of public monies. The privacy notice outlining further information in relation to this form can be found at
https://www.education.ie/en/The-Department/Data-Protection/gdpr/ . Full details of the Department's data
protection policy setting out how we will use personal data as well as information regarding your rights as a data
subject are available at https://www.education.ie/en/The-Department/Data-Protection/. Details of this policy and
privacy notice are also available in hard copy from the address above upon request.
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