[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-287863-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-287863-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","name-change-authorization-form-complete-all-applicable-fields-submit-per-instructions","Name Change Authorization Form - complete all applicable fields - submit per instructions","","Name Change Authorization Form for updating records with Amex Bank of Canada when a cardholder’s name changes. The form collects account and cardmember details, including original and updated names, addresses, and whether the request is for a Basic or Supplementary Cardmember. It requires signatures confirming attached documents are true copies and requests replacement cards when applicable, along with submission of supporting government-issued name-change evidence and required examples such as marriage certificates, divorce decrees, and legal change-of-name documents.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/name-change-authorization-form-complete-all-applicable-fields-submit-per-instructions/287863/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/name-change-authorization-form-complete-all-applicable-fields-submit-per-instructions/287863.png","ImageObject",442,249,{"name":42,"@type":43},"Franzy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-23","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What information must be completed on the form?","Question",{"text":62,"@type":63},"All applicable fields, including account type, account number, original name, changed-to name, and address for the Basic Cardmember, plus supplementary details if applicable.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What documents are required to support the name change?",{"text":67,"@type":63},"Provide a copy of supporting documents issued by a Canadian provincial or territorial government authority evidencing the name change, such as marriage certificates, divorce decrees, legal change-of-name documents, or relevant court orders.",{"name":69,"@type":60,"acceptedAnswer":70},"Who must sign the form for the name change?",{"text":71,"@type":63},"The Basic Cardmember signature is required to change any account information. If the name change is for a Supplementary Cardmember, both Basic and Supplementary Cardmember signatures are required.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},287863,1790146230,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,112,117,122],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":22},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","NAME CHANGE AUTHORIZATION FORM  \n| Please complete all applicable fields and return the form to the address listed at the bottom of this page. Also, please be sure to include a copy of the supporting document(s) issued by a provincial or territorial government authority in Canada evidencing the name change. For examples of supporting documents please see back page. You must complete a separate form for each account affected by the name change. Forms may be submitted together with one copy of the supporting documentation. |\n| --- |\n|  |\n| ACCOUNT INFORMATION\u003Cbr>Account Type: [ ] Credit or Charge Card [ ] Line of Credit\u003Cbr>\u003Cbr>Account Number:   \u003Cbr>Who is the name change request for? [ ] Basic Cardmember [ ] Supplementary Cardmember |\n| BASIC CARDMEMBER INFORMATION\u003Cbr>Original Name:  \u003Cbr>(First Name) (Middle Initial) (Last Name)\u003Cbr>Name Changed to:  \u003Cbr>(First Name) (Middle Initial) (Last Name)\u003Cbr>Address:\u003Cbr>_____________________________________________________________________\u003Cbr>(Street Name)\u003Cbr>(City) (Province) (Postal Code) |\n| SUPPLEMENTARY CARDMEMBER INFORMATION (if applicable)\u003Cbr>Original Name:  \u003Cbr>(First Name) (Middle Initial) (Last Name)\u003Cbr>Name Changed to:  \u003Cbr>(First Name) (Middle Initial) (Last Name) |\n| SIGNATURES\u003Cbr>I certify that the attached document(s) are true copies of the original(s), that my name has changed asset out above, and I request that Amex Bank of Canada update its records and, if applicable, issue replacement Card(s) .\u003Cbr>The Basic Cardmember’s signature is required to change any account information. If the name change is for a Supplementary Cardmember, both Basic and Supplementary Cardmember signatures are required.\u003Cbr>Basic Cardmember Signature (Before Change) Basic Cardmember Signature (After Change) Date\u003Cbr>Supplementary Cardmember Signature (Before Change) Supplementary Cardmember Signature (After Change) Date |\n\nEXAMPLES OF NAME CHANGES AND REQUIRED DOCUMENTATION  \nYou will need to submit one or more of these supporting documents with your application, if  \nrequired.  \nMarriage Certificate or Marriage Registration  \nDivorce Decree  \nLegal Change-of-Name Document  \nConfirms your current family name.  \nConfirms a change in your family name.  \nCertificate or court order issued in accordance with a provincial changeof-name act or similar legislation.  \n\n| Adoption Order | Certified by a Canadian Court (applies to adoptions in Canada only) . |\n| --- | --- |\n| Designated Change\u003Cbr>(example: adding “Dr.” to name) | Any valid government issued identification evidencing the name change (i.e. , Driver’s License) |\n| Hyphenated Names\u003Cbr>(example: Jane Smith-Doe | To add or drop a hyphenated name, any valid government issued identification evidencing the name change is required (i.e. , Driver’s Licence) . |\n\nPlease fax or mail completed forms along with supporting documentation to:  \nAMEX BANK OF CANADA  \nPO BOX 66003 STN BRM B  \nTORONTO, ON, M7Y 4K3  \nFax \\# 1-888-843-9523","cbCaisz3lnMDoNhx","https://ap.wps.com/l/cbCaisz3lnMDoNhx","pdf",37927,"English","# Account information\n# Basic cardmember information\n# Supplementary cardmember information (if applicable)\n# Signatures\n# Examples of name changes and required documentation\n# Submission instructions","[{\"question\":\"What information must be completed on the form?\",\"answer\":\"All applicable fields, including account type, account number, original name, changed-to name, and address for the Basic Cardmember, plus supplementary details if applicable.\"},{\"question\":\"What documents are required to support the name change?\",\"answer\":\"Provide a copy of supporting documents issued by a Canadian provincial or territorial government authority evidencing the name change, such as marriage certificates, divorce decrees, legal change-of-name documents, or relevant court orders.\"},{\"question\":\"Who must sign the form for the name change?\",\"answer\":\"The Basic Cardmember signature is required to change any account information. If the name change is for a Supplementary Cardmember, both Basic and Supplementary Cardmember signatures are required.\"}]","Name Change Authorization Form - complete all applicable fields - submit per instructions | PDF",1789632818]