Name Change Petition Template

IN THE [COURT NAME] COURT OF [STATE/COUNTY]

Case No.: __________________________

Petitioner: [Full Current Legal Name]
Date of Birth: [MM/DD/YYYY]
Address: [Full Address]

1. Petition for Name Change

I, [Petitioner’s Current Full Name], respectfully petition this Court for an order changing my name from [Current Legal Name] to [Proposed New Name].

2. Reason for Name Change

The reason for this request is:
[Describe reason, e.g., marriage, divorce, adoption, gender identity, personal preference, cultural or religious reasons].

3. Residency Requirement

I have been a resident of [County, State] for at least [X months/years], as required by law.

4. Statement of Good Faith

This Petition is not made for the purpose of avoiding debts, criminal liability, or for any fraudulent reason.

5. Minor Children (if applicable)

☐ This Petition includes a request to change the name(s) of the following minor child(ren):

• [Full Name, Date of Birth]

• [Full Name, Date of Birth]

☐ Parental consent has been obtained / notice has been provided as required by law.

6. Public Notice (if required)

Petitioner acknowledges that public notice of this Petition may be required by law, and agrees to comply with publication or posting requirements as directed by the Court.

7. Request for Relief

WHEREFORE, Petitioner respectfully requests that the Court grant this Petition and issue an Order legally changing the name of the Petitioner (and minor children, if applicable) to [Proposed New Name].

Verification

I declare under penalty of perjury that the foregoing is true and correct.

Petitioner Signature: ____________________________
Printed Name: __________________________________
Date: ______________________

Notary / Court Clerk Acknowledgment

On this [Day] of [Month, Year], before me, [Name of Clerk/Notary], personally appeared [Petitioner’s Full Name], who signed and affirmed the above Petition for Name Change.

Signature of Clerk/Notary: ________________________
Commission/Seal: _______________________________