Name Change Petition

IN THE [____________] COURT OF [____________], COUNTY OF [____________], STATE OF [____________]. IN RE THE PETITION OF [____________] FOR CHANGE OF NAME. Case No.: [____________]. PETITION FOR CHANGE OF NAME. Petitioner, [Full Current Legal Name] ("Petitioner"), respectfully petitions this Court for an order granting a legal change of name. Petitioner provides the following identifying information: Full Current Legal Name: [____________]; Date of Birth: [____________]; Place of Birth: [____________]; Current Address: [____________]; Telephone: [____________]; Email: [____________]; Social Security Number (last four digits): [____________]; State Identification / Driver's License Number: [____________].

Petitioner has resided in [____________] County, State of [____________] for [______] years / months. [If applicable: Petitioner is filing on behalf of the following minor child(ren): Name(s): [____________]; Date(s) of Birth: [____________]; relationship to Petitioner: [parent / legal guardian]. The other parent(s) / legal guardian(s) of the minor child(ren) is/are: [Name: ____________, Address: ____________, Relationship: ____________]. [Other parent has been served / consents to this Petition / their consent is not required because: ____________.]] Petitioner attaches a certified copy of Petitioner's birth certificate as Exhibit A.

Petitioner requests that Petitioner's name be changed from [Current Full Legal Name] to [Proposed New Full Legal Name]. The reason(s) for this name change request are as follows: [select and describe all that apply: (a) Marriage, Petitioner recently married [____________] on [____________] and desires to take [spouse's surname / a hyphenated surname / a combined surname]; (b) Divorce, Petitioner was divorced on [____________] and desires to resume a former name; (c) Gender Identity, Petitioner is transitioning and the name change reflects Petitioner's gender identity; (d) Personal Preference, Petitioner wishes to adopt a name that better reflects Petitioner's identity, culture, or heritage; (e) Other: ____________].

This name change is not sought for any fraudulent purpose and Petitioner has not previously changed Petitioner's name except as follows: [none / prior name changes: ____________]. Petitioner has no intention of evading any creditor, judgment, or legal obligation by changing Petitioner's name. Petitioner acknowledges the obligation to update all government-issued identification, financial accounts, and legal documents to reflect the new name, and intends to do so promptly following the Court's order. Petitioner is not a registered sex offender and is not required to register as a sex offender under applicable law [or: Petitioner is required to register and will notify the applicable registering agency as required by law].

Petitioner [has / will] comply with all applicable notice and publication requirements under [applicable state statute, e.g., [State] Code of Civil Procedure § ____________]. [If publication is required:] Petitioner requests that the Court order publication of this Petition in [____________], a newspaper of general circulation published in [____________] County, for [one (1) / four (4)] consecutive week(s), as required by applicable law. [If publication is to be waived:] Petitioner requests that the Court waive the publication requirement for the following reasons: [address confidentiality concerns / safety considerations / gender identity protection / minor child: ____________], pursuant to [applicable exception statute].

Petitioner acknowledges that copies of this Petition and the Court's order, upon issuance, must be provided to the following agencies as required by law: [State Department of Motor Vehicles / Social Security Administration / [State] Department of Health (for birth certificate amendment) / U.S. Passport Agency / other applicable agencies: ____________]. Petitioner has [served / will serve] the [district attorney / state attorney general / other required party: ____________] with a copy of this Petition as required under [statute]. Petitioner will promptly serve all required parties and provide proof of service to the Court.

Petitioner declares under penalty of perjury that: (a) the information provided in this Petition is true and correct to the best of Petitioner's knowledge; (b) this name change is not being sought for the purpose of defrauding any creditor, evading any debt or legal obligation, evading criminal prosecution, or concealing Petitioner's identity for any unlawful purpose; (c) Petitioner has no outstanding criminal judgments, felony convictions on probation or parole, active warrants, or pending criminal proceedings that would affect eligibility for a name change under applicable law [or: Petitioner discloses the following: ____________]; and (d) the proposed new name does not infringe upon the rights of any other person.

WHEREFORE, Petitioner respectfully requests that this Court: (a) grant this Petition and enter an Order changing Petitioner's name from [Current Name] to [Proposed New Name]; (b) direct the Clerk of this Court to issue a certified copy of the Order for use in updating government records; [c) waive the publication requirement for good cause shown;] and (d) grant such other relief as the Court deems just and proper. Petitioner's Signature: [____________]. Printed Name: [____________]. Date: [____________]. [If represented: Attorney Name: ____________, Bar No.: ____________, Firm: ____________, Address: ____________, Phone: ____________, Email: ____________.]