Fill and Sign the Film State of North Carolina in the General Court of Form

Petition for Legal Name Change of MinorPage 1 of 1 STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE SUPERIOR COURT DIVISION COUNTY OF Before the Clerk of Superior Court IN RE: CHANGE OF NAME ) FROM: ) PETITION FOR LEGAL NAME CHANGE (Minor’s current name))OF A MINOR TO: ) (Name Minor’s name should be changed to) ) NOW COME the undersigned, ,and respectfully petitions the Court for an Order to be issued changing the name of the above-named Minor and, to that end, do hereby stat e and show unto the Court: 1. That the Petitioners are residents of the County, North Carolina; and is/are the natural parent Guardian of , the above-named Minor. The Minor is a resident of __________________ County, and has been a resident of __________________ County for at least 6 months prior to the filing of this Petition. 2. That the name of said Minor as shown on his/her birth certificate is . 3. That was born on in County, State of , and the names of his parents as shown on his birth certificate are: FATHER: MOTHER: 4. That your Petitioner(s) desire to change their child’s name for the following reason: 5. That the name of the above-named Minor has not previously been changed by law. 6. That is not a Minor under 16 years of age and is therefore required to provide proof of good character as provided by N.C. Gen. Stat. §101-4. WHEREFORE, your Petitioners respectfully pray the Court enter an Order changing the name of from to . This the day of , . Subscribed and sworn before me Mother’s Signature this the day of , Father’s Signature Notary Public My Commission Expires: