Fill and Sign the Fillable Online Alabama Request to Change Name Form Ps 12

Rev. 8/08  2008 Alabama State Bar PS–12 8/08 Request to Change Name (For An Adult) Case Number: (the clerk fills this in) In the Probate Court of (county): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ County, Alabama Your current name: first middle last To ask the court to change your name, you must fill out this form, and: • Attach a certified copy of your birth certificate and a copy of your photo ID, and • File your form and attachments in the same county where you live. I declare that the following information is true: q My current name is: first middle last w My address is: street city state zip e My phone numbers are (home): (work): r My date of birth is (mm/dd/yyyy) : t My name at birth was: first middle last y I am an adult (19 or older), of sound mind, and live in (name of Alabama county): u The attached copy of my photo ID is my (check one):  Driver’s license, #  Non-driver’s photo, ID #: i I ask the court to change my name because (explain why you want to change your name): o I want my new name to be: first middle last a I also declare: • I am not now facing criminal charges, nor am I involved in any other court case. • I have never been convicted of a criminal sex offense (as defined in Alabama Code § 15-20-21), a crime of moral turpitude, or a felony. • I am not asking to change my name to avoid paying my debts or to commit fraud. • I swear that all of the information I have provided above is complete and accurate. I ask the court to grant this request and to issue an order changing my name. Sign below in front of a notary: Date: Notary fills out below— Sworn to and subscribed before me, the undersigned authority, By (Print name of notary): On this date: Notary signs here Date notary’s commission expires (Notary’s seal here) / /