Fill and Sign the Change Name a Make Form

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.982(a) PETITION FOR CHANGE OF NAME (ADULT) (02/18) When should this form be used? This form should be used when an adult wants the court to change his or her name. This form is not to be used in connection with a dissolution of marriage or for adoption of child(ren). If you want a change of name because of a dissolution of marriage or adoption of child(ren) that is not yet fnall the change of name should be requested as part of that case. This form should be typed or printed in black ink and must be signed before a notary public or deputy clerk . You should file the original with the clerk of the circuit court in the county where you live and keep a copy for your records. What should I do next? Unless you are seeking to restore a former name, you must have fingerprints submitted for a state and national criminal records check. The fngerprints must be taken in a manner approved by the eepartment of aaw Enforcement and must be submitted to the eepartment for a state and national criminal records check. You may not request a hearing on the petition until the clerk of court has received the results of your criminal history records check . The clerk of court can instruct you on the process for having the fngerprints taken and submittedl including information on law enforcement agencies or service providers authorized to submit fngerprints electronically to the eepartment of aaw Enforcement. The process may take several weeks and you will have to pay for the cost of processing the fngerprints and conducting the state and national criminal history records check. Please note that the state and national criminal records check must indicate whether you have registered as a sexual predator or a sexual ofender and you must also indicate on this petition whether you have ever been required to register as a sexual predator under section 775.21, Florida Statutes, or as a sexual ofender under section 943.0435, F.S. Nextl you must obtain a hearing date for the court to consider your request. If you are seeking to restore a former namel a hearing on the petition MAY be held immediately after the petition is fled. The fnal hearing on any other petition for a name change may be held immediately after the clerk of court receives the results of your criminal history records check. You should ask the clerk of courtl family law intake staf l or judicial assistant about the local procedure for setting a hearing. You may be required to attend the final hearing . Included in these forms is a Final Judgment of Change of Name (Adult) l Florida Supreme Court Approved Family aaw Form 12.982(b)l which the judge may use. You should contact the clerkl Instructions for Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) family law intake stafl or judicial assistantl to see if you need to bring a final judgment form with you. If sol you should type or print the headingl including the circuitl countyl case numberl divisionl and the parties’ namesl and leave the rest blank for the judge to complete at your hearing or trial. If the judge grants your petition l he or she will sign this order . This officially changes your name. The clerk can provide you with certified copies of the signed order. There will be charges for the certifed copiesl and the clerk can tell you the amount of the charges. Where can I look for more information? Before proceeding, you should read General Information for Self - Represented Litigants found at the beginning of these forms. For further informationl see Section 68.07l Florida Statutes. IMPORTANT INFORMATION REGARDING E-FILING The Florida Rules of Judicial Administration ow require that all petitionsl pleadingsl and documents be fled electronically except in certain circumstances. Self- represented litigants may file petitions or other pleadings or documents electronically; however, they are not required to do so. If you choose to fle your pleadings or other documents electronicallyl you must do so in accordance with Florida Rule of Judicial Administration 2.525l and you must follow the procedures of the judicial circuit in which you fle. The rules and procedures should be carefully read and followed. IMPORTANT INFORMATION REGARDING E-SERVICE ELECTION After the initial service of process of the petition or supplemental petition by the Sherif or certifed process serverl the Florida Rules of Judicial Administration now require that all documents required or permitted to be served on the other party must be served by electronic mail (e-mail) except in certain circumstances. You must strictly comply with the format requirements set forth in the Rules of Judicial Administration. If you elect to participate in electronic servicel which means serving or receiving pleadings by electronic mail (e-mail)l or through the Florida Courts E-Filing Portall you must review Florida Rule of Judicial Administration 2.516. You may fnd this rule at www.flcourts.org through the link to the Rules of Judicial Administration provided under either Family aaw Forms: Getting Startedl or Rules of Court in the A-Z Topical Index. SELF-REPRESENTED LITIGANTS MAY SERVE DOCUMENTS BY E-MAIL; HOWEVER, THEY ARE NOT REQUIRED TO DO SO. If a self-represented litigant Instructions for Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) elects to serve and receive documents by e-maill the procedures must always be followed once the initial election is made. To serve and receive documents by e-maill you must designate your e-mail addresses by using the Designation of Current Mailing and E-mail Address l Florida Supreme Court Approved Family aaw Form 12.915l and you must provide your e-mail address on each form on which your signature appears. Please CAREFULLY read the rules and instructions for: Certificate of Service (General), Florida Supreme Court Approved Family aaw Form 12.914; Designation of Current Mailing and E-mail Address l Florida Supreme Court Approved Family aaw Form 12.915; and Florida Rule of Judicial Administration 2.516. Special notes... The heading of the form calls for the name of the petitioner . Your current name should go therel as you are the one who is asking the court for something. The judicial circuitl case numberl and division may be obtained from the clerk of court’s office when you fle the petition. It may be helpful to compile a list of all of the people and/or places that will need a copy of your fnal judgment. This list may include the driver’s license officel social security officel banksl schoolsl etc. A list will help you know how many copies of your order you should get from the clerk of court after your hearing. Rememberl a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fll out these formsl that person must give you a copy of a Disclosure from Nonlawyer l Florida Family aaw Rules of Procedure Form 12.900 (a)l before he or she helps you. A nonlawyer helping you fll out these forms also must put his or her namel addressl and telephone number on the bottom of the last page of every form he or she helps you complete. Instructions for Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) IN THE CIRCUIT COURT OF THE ____________JUeICIAa CIRCUITl IN ANe FOR______________________COUNTYl FaORIeA IN RE: THE NAME CHANGE OF Case No.: ________________________ eivision: _________________________ _______________________________l Petitioner. PETITION FOR CHANGE OF NAME (ADULT) Il {full legal name} _________________________________l being swornl certify that the following information is true: 1. My complete present name is: _______________________________________________________ I request that my name be changed to: ________________________________________________ 2. I live in _________________ Countyl Floridal at {street address} _____________________________ _________________________________________________________________________________ 3. I was born on {date}______________ l in {city} _________________________l {county} __________l {state} ______________________l {country} _________________. 4. My parents’ full legal names are : a. ___________________________________________ b. __________________________________________ c. {If applicable } My parents’ maiden name(s) is/are: ____________________________ and __________________________________________________________________ 5. I have lived in the following places since birth: eates (to/from) Address _______/_________ ____________________________________________________ _______/_________ ____________________________________________________ Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) _______/_________ ____________________________________________________ _______/_________ ____________________________________________________ (___ Please indicate here if you are continuing these facts on an attached page.) 6. Family [Indicate all that apply] a._____ I am not married. b._____ I am married. My spouse’s full legal name is: _____________________________ c._____ I do not have child(ren). d._____ The name(s)l age(s)l and address(es) of my child(ren) are as follows (all childrenl including those over 18 l must be listed): Name {last, frst, middle initial} Age Address, City, State _______________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ (______Please indicate here if you are continuing these facts on an attached page. ) 7. Former names [Indicate all that apply] a. _____ My name has never been changed by a court . b. _____ My name previously was changed by court order from ______________________ to ________________________________on {date} ____________________________ l by {court, city, and state} ______________________________________________________ _________________________________________________________________________. A copy of the court order is attached . c. _____My name previously was changed by marriage from _______________________ to ___________________________________ on {date} ____________________________ in {city, county, state} _______________________________________________________. Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) A copy of the marriage certificate is attached . d. _____I have never been known or called by any other name. e. _____ I have been known or called by the following other name(s): {list name(s) and explain where you were known or called by such name(s)} __________________________ __________________________________________________________________________ 8. Occupation My occupation is: . I am employed at: {company and address} . euring the past 5 yearsl I have had the following jobs: eates (to/from) Employer and employer’s address _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ (_______Please indicate here if you are continuing these facts on an attached page.) 9. Business [Choose one only] __ I do not own and operate a business. __ I own and operate a business. The name of the business is: ___________________________ The street address is: . My position with the business is: . I have been involved with the business since: {date} . 10. Profession [Choose one only] _ I am not in a profession. Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) _ I am in a profession. My profession is: _________________________________________ I have practiced this profession: eates (to/from) Place and address _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ _______/_______ __________________________________________________________ ( _____ Please indicate here if you are continuing these facts on an attached page.) 11. Education I have graduated from the following school(s): eegree eate of Received Graduation School _________ _____________ __________________________________________________ _________ _____________ __________________________________________________ _________ _____________ __________________________________________________ (________ Please indicate here if you are continuing these facts on an attached page. ) 12. Criminal History Indicate all that apply _ I have never been arrested for or charged withl pled guilty or nolo contendere tol or been found to have committed a criminal ofensel regardless of adjudication. _ I have a criminal history. In the past I have been arrested for or charged withl pled guilty or nolo contendere tol or been found to have committed a criminal ofensel regardless of adjudication. The details of my criminal history are: eate City/State Event (arrestl chargel pleal or adjudication) ( _______ Please indicate here if you are continuing these facts on an attached Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) page.) I _____ have____have not ever been required to register as a sexual predator under section 775.21l Florida Statutes. I _____ have ______have not ever been required to register as a sexual ofender under section 943.0435l Florida Statutes. 13. Bankruptcy [Choose one only] _ I have never been adjudicated bankrupt. _ I was adjudicated bankrupt on {date} l in {city} , {county} l {state} . (______ Please indicate here if you have fled additional bankruptciesl and explain on an attached page.) 14. Creditor(s)’ Judgments [Choose one only] _ I have never had a money judgment entered against me by a creditor. _ The following creditor(s)’ money judgment(s) have been entered against me: eate Amount Creditor Court entering judgment and case number if Paid {date} _________ _________ _________ _______________________________________________ _________ _________ _________ _______________________________________________ _________ _________ _________ _______________________________________________ _________ _________ _________ _______________________________________________ (_______ Please indicate here if these facts are continued on an attached page.) 15. Fingerprints and Criminal History Records Check Unless I am seeking to restore a former namel a copy of my fngerprints has been taken in a manner approved by the eepartment of aaw Enforcement and submitted for a state and national criminal history records check. I understand that I cannot request a hearing on my Petition until the Clerk of Court receives the results of the criminal history records check. I also understand that the state and national records check must indicate whether I have registered as either a sexual predator or sexual ofender. Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) 16. I have no ulterior or illegal purpose for fling this petitionl and granting it will not in any manner invade the property rights of othersl whether partnershipl patentl good willl privacyl trademarkl or otherwise. 17. My civil rights have never been suspendedl orl if my civil rights have been suspendedl they have been fully restored. I understand that I am swearing or afrming under oath to the truthfulness of the claims made in this petition and that the punishment for knowingly making a false statement includes fines and/or imprisonment. eated: ______________________ _____________________________________________ Signature of PETITIONER Printed Name: _________________________________ Address: _____________________________________ Cityl Statel Zip: ________________________________ Telephone Number: _____________________________ Fax Number: __________________________________ eesignated E-Mail Address(es):____________________ _____________________________________________ STATE OF FaORIeA COUNTY OF ____________________ Sworn to or affirmed and signed before me on ____________ by _______________________________. _____________________________________________ NOTARY PUBaIC or eEPUTY CaERK _____________________________________________ [Print, type, or stamp commissioned name of notary or deputy clerk.] ____ Personally known ____ Produced identifcation Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18) ____ Type of identifcation produced ________________________________ IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW: [fll in all blanks] This form was prepared by the Petitioner. This form was completed with the assistance of:_____________________________________________ { name of individual} ___________________________________________________________________l {name of business}:____________________________________________________________________, {address } ____________________________________________________________________________l {city} ________________l {state}_____,{zip code}________,{telephone number} __________________. Florida Supreme Court Approved Family aaw Form 12.982(a)l Petition for Change of Name (Adult) (02/18)