Application for Change of Name



To: _______________________________ (Court)

Applicant states:

1. Applicant resides at ___________________________________________ (Address), and has resided there for more than __________ (Months or Years) prior to filing this application.

2. Applicant was born in _________________________________________ (Address) on _____________ (Date of Birth). Applicants birth name is __________________.

3. The name of applicant's father is ______________________________, and his address is _____________________________________________________. The name of applicant's mother is _________________________and her address is _______________________________________.

4. Applicant is _________ (Married/Single) . If married, applicant was married to:

______________________ (Spouse's Name) on ___________________ (Date) at __________________________________________________ (Location and Address).

Spouse's Date of Birth: _________________________________________________

Spouse's Place of Birth: _________________________________________________

5. Applicant desires to change her name to ______________________________ for the following reasons: _____________________________________________________.

6. _____________________________________________________(State here any information relating to publication of notice of intent to change name, which may be required by statute.)

7. _____________________________________________________(State here any information required by statute as to financial matters, any criminal records, and pending actions or other proceedings to which the applicant may be a party.)


_______________________ ____________________

Signature Date




These forms are provided AS IS. They may not be any good. Even if they are good in one jurisdiction, they may not work in another. And the facts of your situation may make these forms inappropriate for you. They are for informational purposes only, and you should consult an attorney before using them.

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