Application for Change of Name
This form is an application to change your name. The form provided here is simply a sample of what the actual form looks like.
APPLICATION FOR CHANGE OF NAME
To: _______________________________ (Court)
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 the name of applicant's mother is _____________________________.
They reside at ______________________________________ (Address).
4. Applicant _________ (Is/Is Not) married.
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 (his/her) name to ____________________
for the following reasons:
(State here any information relating to publication of notice of intent to change name, which may be required by statute.)
(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.)