Fill and Sign the Missouri Change Form

IN THE CIRCUIT COURT OF _________________ COUNTY, MISSOURI AT ________________________ In re the Matter of: ) )       ) Case No. Minor Petitioner ) VERIFIED PETITION FOR NAME CHANGE OF A MINOR COMES NOW _________________ , as Parent and Next Friend of the Minor, _________________ , by this petition, and upon being duly sworn, respectfully represents and shows unto the Court: 1. The present name of the Minor Petitioner and the name desired is as follows: a. Present name:       b. Name desired:       2. The reason for the desired change is as follows: a.       b.       3. The Minor Petitioner is a resident of the county in which the change of name is sought. a. Minor Petitioner’s residence:       4. Minor Petitioner’s date of birth:       5. Minor Petitioner’s place of birth:       6. Minor Petitioner’s father’s name is:       7. Minor Petitioner’s mother’s maiden is:       8. Minor Petitioner is not married or, is married. If married, Minor Petitioner’s spouse’s name is:       9. Minor Petitioner has ____________ children. 10. Names of the children are:       Verified Petition for Name Change of Minor Page 1 of 3 11. Minor Petitioner’s name has not been previously changed, or Was previously changed as follows:       12. There are: no unsatisfied money judgments presently pending against the Minor Petitioner, or the following unsatisfied money judgments are pending against the Minor Petitioner:       13. There are: no actions for money presently pending against the Minor Petitioner, or the following actions for money are pending against the Minor Petitioner:       14. The proposed change in the Minor Petitioner’s name, if granted, will not be detrimental to the interests of any other person. 14. The Minor Petitioner is not confined to a department of corrections facility. 15. This Petition is not filed to defraud creditors. Wherefore, the Minor Petitioner prays that, by an Order of this Court, made and entered herein, the Petitioner’s name be changed to and decreed to be:       . ` Respectfully Submitted, _______________________________________ Signature of Parent Guardian Address:             Phone:       _______________________________________ Signature of Parent Guardian Address:             Phone:       Verified Petition for Name Change of Minor Page 2 of 3 Subscribed and sworn to before me on this the Day of CLERK OF THE CIRCUIT COURT Notary Public By : Deputy Clerk My Commission Expires: Verified Petition for Name Change of Minor Page 3 of 3