Eligibility
You can use your common-law spouse’s surname if you:
- have been living together for 2 years; or
- have a child together and are living in a relationship of some permanence.
Process for using common-law spouse’s surname
- Complete and submit the Use of Common-Law Spouse’s Last Name Statutory Declaration form.
You can choose to use the name your spouse had at birth or the name your spouse had when you started living together
OR
You can choose to use a hyphenated or double surname using your surname and your spouse’s.
- Once your form has been processed by the Health Services Administration Office, a certified copy will be provided to you.
You can use the certified copy as proof that you have chosen to use your spouse’s surname.
Prerequisites
To ensure your application is successful, please see the information on eligibility and fees.
Forms
Fees
- $22.00
Contact this Service
Phone: 1-800-661-0830 (toll free)
Email: hsa@gov.nt.ca
Hours: 9:00 AM – 4:30 PM (Monday to Friday, closed statutory holidays)
Sending the Completed Form…
Registrar General of Vital Statistics
Health Services Administration Office
Bag #9
Inuvik, NT X0E 0T0