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Form #1396Petition on application for change of name
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Petition on application for change of name
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Petition on application
for change of name.
County
Court, County of _________
In the Matter of the Application of _________
for leave to assume another name
To the County Court of the County of _________
The petition of _________, respectfully alleges that:
1. Petitioner resides at No. _________ street in the
city of _________, county of _________ and state of _________, and has so
resided for a period of _________ years and _________ months prior to the
making of this application.
2. Petitioner desires to assume another name than now
held by him and that the name which he proposes to assume is _________.
3. The grounds for this application for such change of
name are as follows: _________(State grounds of application in detail.).
4. Petitioner is not married and has no children.
5. Petitioner is a citizen of the United States of
America (having been duly naturalized by the _________ county on the _________
day of _________).
6. Petitioner was born at _________ on the _________
day of _________, _________ [date], and is now _________ years of age.
The name of petitioner's father is _________ and the name of petitioner's
mother is _________.
7. Petitioner, under the name by which he is now known
or under any other name he has ever used, has never been convicted of a crime
and has never been adjudicated a bankrupt.
8. There are no judgments or liens of record and no
actions pending against petitioner in any court of this state or of the United
States, or of any governmental subdivision thereof, or elsewhere, whether the
court be of record or not. There are no bankruptcy or insolvency proceedings,
voluntary or involuntary, pending against petitioner in any court whatsoever or
before any officer, person, body or board having jurisdiction thereof and
petitioner has not at any time made any assignments for the benefit of
creditors.
9. There are no claims, demands, liabilities or
obligations of any kind whatsoever on a written instrument or otherwise against
petitioner under the only name by which he has been known, which is the name
sought herein to be abandoned, and petitioner has no creditors who may be
adversely affected or prejudiced in any way by the proposed change of name.
10. [Where applicant was born in the state of
_________.] Annexed to this petition and made a part hereof is a birth
certificate of petitioner.
11. No prior application for this or other similar
relief has been made.
Wherefore petitioner prays that an order of this court
may be entered granting leave to him to assume the name of _________ in place
of that of _________ on a day to be specified therein not less than 30 days
after the entry of such order, and for such other and further relief as may be
proper.
_________ [date].
_________,
Petitioner
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or any other commercial use is prohibited. This includes reposting forms from this
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Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
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to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
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Keywords: Petition,application,change,name
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