Legal Motion for Name

LEGAL MOTION FOR NAME

Court:   County:   Case No.:

Petitioner Name:   Current Address:

RECITALS

WHEREAS, Petitioner is an adult resident of the jurisdiction of this Court and presently resides at the address set forth above; and

WHEREAS, Petitioner was born with the name: , on in ;

WHEREAS, Petitioner seeks to change his or her name to: for the reasons set forth below.

NOW THEREFORE

Petitioner respectfully moves the Court for an order changing Petitioner's name and in support thereof alleges the following:

1. JURISDICTION

This Court has jurisdiction over this matter pursuant to applicable state statutes because Petitioner resides within the territorial jurisdiction of this Court and has been a resident for at least .

2. PETITIONER INFORMATION

3. GROUNDS FOR REQUEST

Petitioner seeks the change of name for legitimate and non-fraudulent purposes including, but not limited to: . Petitioner affirms that the change is not sought to avoid debts, criminal liability, or to interfere with the rights of others.

4. PROPOSED NEW NAME

Petitioner requests that the Court change Petitioner's name from to .

5. NOTICE AND PUBLICATION

Petitioner will comply with statutory notice requirements. Petitioner requests (select one): Standard publication of notice Waiver of publication (for safety or privacy concerns)

6. CRIMINAL HISTORY AND LIENS

Petitioner certifies (select one): No prior felony convictions Has prior convictions (explain below)

7. MINOR CHILDREN

Are there minor children whose names will be affected? Yes No

8. SUPPORTING DOCUMENTS

Petitioner attaches the following documents in support of this Motion (check all that apply):

Birth certificate   Government-issued ID   Proof of residence   Other (describe below)

9. RELIEF REQUESTED

Petitioner respectfully requests that the Court enter an order that:

1. Changes Petitioner's name from the current legal name to the proposed new name set forth in this Motion;
2. Authorizes the issuance of a certified copy of the order to update governmental and private records;
3. Grants such other and further relief as the Court deems just and proper.

10. CERTIFICATION

I declare under penalty of perjury under the laws of this jurisdiction that the foregoing is true and correct to the best of my knowledge and belief.

ATTORNEY / REPRESENTATIVE (IF APPLICABLE)

MISCELLANEOUS PROVISIONS

Governing Law: This Motion and any order entered hereunder shall be governed by the laws of the State in which this Court is located.

Entire Agreement: This Motion contains the entire request of Petitioner regarding the matters set forth herein and supersedes any prior oral or written statements relating to the requested name change.

Severability: If any provision of this Motion is determined to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Notices: All notices required or permitted by this Motion shall be in writing and served in accordance with the rules of this Court to the addresses provided above.

Amendments and Waiver: This Motion may be amended in writing. Failure to insist upon strict performance of any provision shall not operate as a waiver of any subsequent default.

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