Fill and Sign the Handbook for Town and Village Justices and Court Clerks PDF Form

AFFIDAVIT- 1 - Civil Court of the City of New York County of Index Number In the Matter of the Application of AFFIDAVIT for Leave to Change His/Her Name To State of New York ) ) County of ) , an adult, having been first duly sworn according to law, on oath deposes and states as follows:1. That is the Petitioner in the above-entitled matter in which Petitioner seeks to change name from to . 2. That the Petitioner is currently a resident of County, New York. 3. That the Petitioner is: unmarried and has not been previously married; unmarried and was previously married to , whose current address is ; married to , whose address is and has not been previously married; or married to , whose address is and was previously married to , whose address is . AFFIDAVIT- 2 - 4. That the Petitioner does not have any children has ___children. The names, ages and addresses of Petitioner’s children are as follows: NAME AGE DOB ADDRESS Dated this day of , 20 . Petitioner Type or Print Name being duly sworn, deposes and says: I am the petitioner in the above-captioned action. I have read the affidavit and know the contents to be true to my own knowledge, except to those matters alleged on information and belief and as to those matters I believe them to be true. ____________________________________PETITIONER Sworn to before me on this the day of , 20 . ____________________________________ NOTARY