Fill and Sign the Mississippi Petition Change Form

IN THE CHANCERY COURT OF ___________________ COUNTY, MISSISSIPPI IN THE MATTER OF THE PETITION OF _______________________ , PETITIONER FOR CHANGE OF NAME CAUSE NO. __________________ PETITION TO CHANGE NAME COMES NOW the Petitioner, __________________ , who would respectfully petition the Court the following, to-wit: 1. This Honorable Court has jurisdiction over the parties and subject matter. 2. Petitioner, __________________ , is an adult bona fide resident citizen of __________________ County, Mississippi, whose current residence and mailing address is __________________ , __________________ , Mississippi __________________ . Petitioner has been such for more than six (6) months preceding the date of filing of this Petition; this Court has proper jurisdiction of the Petitioner and of the subject matter. 3. Petitioner was born on __________________ , to __________________ and __________________ in __________________ , his/her Social Security Number is __________________ . 4. Petitioner desires to change his/her name to “ __________________ ”. Petitioner would state as grounds for the change of name as follows: __________________ . 5. Petitioner would show that Petitioner is not the convict of a felony and that this Petition is not filed to change the name of Petitioner for any unlawful purpose nor to commit fraud on any person. Petitioner has never filed bankruptcy and there are no claims, demands, liabilities or obligations of any kind whatsoever against Petitioner that would be adversely affected by this Petition. No Creditors of Petitioner would be adversely affected by granting this Petition. 6. Petitioner would show that it is appropriate and in accordance with the Mississippi Code Section 93-17-1 (1972) and is in the best interest of Petitioner that this Petition be granted. WHEREFORE, PREMISES CONSIDERED, Petitioner respectfully prays that this his Petition to Change Name be received and filed and that upon a final hearing of this cause the Court will enter its Order changing the name of Petitioner from __________________ to __________________ . Respectfully submitted, _________________________ Signature Name: __________________ STATE OF MISSISSIPPI COUNTY OF __________________ PERSONALLY APPEARED before me, the undersigned authority in and for the jurisdiction aforesaid, the within named Petitioner, __________________ , who having been by me first duly sworn, stated upon his/her oath that the matters and facts contained in the above and foregoing Petition to Change Name are true and correct as therein stated. ____________________________________ Signature of Petitioner GIVEN UNDER MY HAND AND OFFICIAL SEAL, this the __________________ day of __________________ , 20 ___ . __________________________ NOTARY PUBLIC MY COMMISSION EXPIRES: _________________________