Fill and Sign the La Cc Art 103 1 Divorce Form Packet

Petition to Change Name of Minor Page 1 of 1 __________________ JUDICIAL DISTRICT PETITIONER PARISH / CITY OF STATE OF LOUISIANA DIVISION: NUMBER: DEFENDANT FILED: CLERK: PETITION TO CHANGE NAME OF MINOR The petition of ______________________________, the parent or guardian of ________________________, a minor, who is a resident of and domiciled in the Parish of __________________, State of Louisiana, w ishes to change minor child’s name to ________________________ for the following reasons: ______________________________. The minor, ________________________, was born on the ______ day of ____________, ______. Her Social Security number is - - . She resides at : ______________________________. This suit is brought under R.S. 13:4751 – 13:4755, and it is thus mandatory that the District Attorney of this Parish be served with a copy of this petition and cited to answer it. WHEREFORE, petitioner prays for Judgment changing minor child’s name from ________________________ to ________________________. By: ______________________________ STATE OF LOUISIANA PARISH OF ________________________ BEFORE ME, the undersigned Notary Public, duly commissioned and legally qualified in and for the Parish and State aforesaid, personally came and appeared __________________ who, being first duly sworn, did depose and say that: 1. He is the Petitioner in the above and foregoing proceedings; 2. He has read the same; and 3. All of the allegations of fact contained therein are true and correct, to the bes t of his knowledge, information, and belief. ___________________________________ SWORN TO AND SUBSCRIBED before me this ____ day of _______________ ____. _________________________________ NOTARY PUBLIC