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    Name Change

    Uploaded by

    Aleria Butler
    This petition requests to change a minor child's name from their current name to a new name. It provides details of the child such as their birthdate, birthplace, and current address. It states that the child's birth name and notes any previous name changes. The petition specifies whether the child is or has been registered as a sexual offender. It gives the proposed new name and reasons for the name change. Finally, it provides names and addresses of the child's parents/guardians and whether they consent to the name change.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Name Change

    Uploaded by

    Aleria Butler
    102 views2 pages
    This petition requests to change a minor child's name from their current name to a new name. It provides details of the child such as their birthdate, birthplace, and current address. It states that the child's birth name and notes any previous name changes. The petition specifies whether the child is or has been registered as a sexual offender. It gives the proposed new name and reasons for the name change. Finally, it provides names and addresses of the child's parents/guardians and whether they consent to the name change.

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    Original Title

    Name change

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    © Attribution Non-Commercial (BY-NC)

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    This petition requests to change a minor child's name from their current name to a new name. It provides details of the child such as their birthdate, birthplace, and current address. It states that the child's birth name and notes any previous name changes. The petition specifies whether the child is or has been registered as a sexual offender. It gives the proposed new name and reasons for the name change. Finally, it provides names and addresses of the child's parents/guardians and whether they consent to the name change.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    102 views2 pages

    Name Change

    Uploaded by

    Aleria Butler
    This petition requests to change a minor child's name from their current name to a new name. It provides details of the child such as their birthdate, birthplace, and current address. It states that the child's birth name and notes any previous name changes. The petition specifies whether the child is or has been registered as a sexual offender. It gives the proposed new name and reasons for the name change. Finally, it provides names and addresses of the child's parents/guardians and whether they consent to the name change.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    *

    *
    IN THE MATTER OF: IN THE
    *
    CIRCUIT COURT
    Child's Current Name *
    FOR
    Street Address
    *
    City, State, Zip
    *
    Telephone
    *
    FOR CHANGE OF NAME TO:
    * Civil No.:
    Child's New Name
    *
    BY AND THROUGH HIS/HER
    MOTHER/FATHER/GUARDIAN: *

    *
    Petitioner's Name
    * * * * * * * * * * * * * * *

    PETITION FOR CHANGE OF NAME


    (Minor)
    (DOM REL 62)

    TO THE HONORABLE, THE JUDGE OF SAID COURT:

    Petitioner, , a minor, by and through


    Child's Current Name
    his/her Mother Father Guardian respectfully represents to this Court:
    Check One

    1. That the minor child was born on in


    Child's Birthdate Child's Birthplace - City, State, Country

    and presently resides at


    Child's Present Address

    2. That the child's birth name is .


    Child's Birth Name
    The child's name has been changed to the following since birth for the following reasons:
    (List any reasons why the child's name may have changed since birth, for example, adoption).
    Name Changed To: Reason:

    I have attached a birth certificate or other document reflecting the child's current name.

    Page 1 of 2
    DR 62 (Rev. 9/2005)
    3. Select one of the following:
    The child has never registered as a sexual offender; OR
    The child is or has previously been registered as a sexual offender under
    the following name:
    . Full Name as Registered

    4. Petitioner wishes to change the child's name to:


    Child's New Name
    .
    5. This change of name is being requested because:

    6. The name and address of each parent, guardian and custodian of the child is:

    7. The other parent, guardian or custodian:


    Consents to and joins this petition.
    Has not consented at this time.
    Cannot be found, and I have attached an Affidavit and Motion to Serve by Alternative
    Means.
    8. Petitioner hereby certifies that the above change of name is not requested for any illegal or
    fraudulent purposes.
    WHEREFORE, I respectfully request that the Court pass an Order changing the minor child's
    name from to .
    Current Name New Name

    I, , solemnly affirm under the penalties


    of perjury, that the contents of the foregoing paper are true to the best of my knowledge, information and
    belief.
    Your Signature - MOTHER/FATHER/GUARDIAN
    Date
    Your Name - Printed

    Address

    City, State, Zip

    Telephone

    Page 2 of 2
    DR 62 (Rev. 9/2005)

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