Fidelity Advisor Name Change Authorization Form Completed Form Examples and Samples
Explore real-world examples and samples of the Fidelity Advisor Name Change Authorization Form, including marriage, divorce, court order, and other legal name change scenarios. Learn how to correctly fill out each field, what supporting documents to include, and how to avoid common errors when submitting your Fidelity Advisor name change request.
Fidelity Advisor Name Change Authorization Form Example – Marriage Name Change
How this form was filled:
This example shows how to correctly complete the Fidelity Advisor Name Change Authorization Form when an account holder has legally changed their name following marriage. The form includes the account holder's former name, new legal name, account number, reason for name change, supporting documentation type, and an authorized signature with date. This is one of the most common reasons individuals submit this form to Fidelity Advisor accounts.
Information used to fill out the document:
- Current (Former) Account Owner Name: Sarah L. Harrington
- New Legal Name: Sarah L. Mitchell
- Account Number: Z12-345678
- Account Type: Individual Brokerage Account
- Reason for Name Change: Marriage
- Supporting Document Provided: Marriage Certificate
- Date of Legal Name Change: 03/15/2025
- Social Security Number (Last 4 Digits): 7892
- Advisor / Representative Name: James R. Thornton
- Advisor Firm Name: Thornton Wealth Management Group
- Branch Office Number: BRN-00412
- Advisor CRD Number: 1234567
- Authorized Signature (Account Owner): Sarah L. Mitchell
- Signature Date: 01/08/2026
- Daytime Phone Number: (614) 555-0193
- Mailing Address: 47 Elmwood Drive, Columbus, OH 43215
What this filled form sample shows:
- Correctly populated former name and new legal name fields reflecting a post-marriage name change
- Accurate account number and account type identification for proper record matching
- Clearly indicated reason for name change (Marriage) with corresponding supporting document type (Marriage Certificate)
- Inclusion of advisor and firm details including CRD number and branch office number for broker-dealer compliance
- Properly completed authorized signature using the new legal name, along with a correctly formatted signature date
- Last 4 digits of Social Security Number provided for identity verification purposes
Form specifications and details:
| Use Case: | Legal name change due to marriage on an individual Fidelity Advisor brokerage account |
| Form Name: | Fidelity Advisor Name Change Authorization Form |
| Account Owner Type: | Individual (Natural Person) |
| Account Type: | Individual Brokerage Account |
| Name Change Reason: | Marriage |
| Documentation Required: | Marriage Certificate |
| Advisor Involvement: | Required – Advisor must complete firm and representative details |
| Signature Requirement: | Account owner must sign using new legal name |
| Processing Entity: | Fidelity Advisor (Broker-Dealer Channel) |
| Applicable Region: | United States |
Created: February 25, 2026 06:14 AM
