Fill and Sign the Arizona Change Name Adult Form

Name of Person Filing Document:       Your Address:       Your City, State, Zip Code:       Your Telephone Number:       Attorney Bar Number (if applicable):       Representing Self (Without an Attorney) OR Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN       COUNTY In the Matter of: Case Number:       ORDER CHANGING NAME OF AN ADULT       Name of Applicant THE COURT FINDS: 1. This case has come before this Court to Change the Legal Name of the Applicant. 2. This Court has jurisdiction to change the name of the Applicant. 3. Good cause exists to grant the application for Change of Name. THE COURT ORDERS: 1. That the current legal name of the Applicant:       (First) (Middle) (Last) Birth date:       Birthplace:       (Month, Day, Year) (City, State, Nation) is changed to       . (First) (Middle) (Last) 2. For a person born in the State of Arizona, the Office of Vital Records is ordered to amend the birth record to reflect the new name as ordered above. For a person born in a state other than Arizona, to the extent that the agency that maintains birth records in that state is authorized to honor an order of this Court, that agency is requested or ordered to amend it’s birth records to reflect the new name as ordered above. 3. This Order does not release the Applicant from any obligation incurred or harm any rights of property or action in any original name. 4. Other orders:       DONE IN OPEN COURT:       Date Judicial Officer For Clerk’s Use Only