I am writing to request the amendment of my details in the baptismal register for the parish of [Baptismal Parish Name] in the diocese of [Baptismal Diocese Name], where I was baptised. I am currently resident in the Diocese of [Diocese of Residence Name].
I recently discovered that since I was baptised as a child, at an age when I could not give consent, I continue to be included in the church's internal statistics. I cannot in good conscience allow myself to remain counted among the congregation of the Catholic Church and thus I respectfully request that you amend the baptismal register to reflect this wish.
I enclose a completed and signed "Declaration of Defection", along with my personal details. In addition, I would be grateful if you could communicate with me once these changes have been made.
[Your Name Here]