Fill and Sign the Missouri Name Change 497313381 Form

IN THE CIRCUIT COURT OF ____________ COUNTY, MISSOURI AT ________________________ In Re the Petition of:       )       )       )       )       )       ) CASE NO.       ) For a Change of Name to: ) )       )       )       )       )       )       ) ) JOINT VERIFIED PETITION FOR NAME CHANGE COMES PETITIONERS ________________________ and ________________________ by this petition, and upon being duly sworn, respectfully represents and shows unto the Court: A. 1. Petitioner’s present name is: ______________________________ . 2. Petitioner requests a change of name to: ______________________________ . 3. That the Petitioner prays for the change of name for the following reasons: (describe in detail): ____________________________________________________________ . 4. That the Petitioner is of full legal age and is a bona fide resident of the County of ________________________ . 5. Petitioner’s date of birth: ________________________ . 6. Petitioner’s place of birth: ________________________ . 7. Petitioner’s father’s name is: ______________________________ . 8. Petitioner’s mother’s maiden is: ______________________________ . 9. Petitioner’s spouse’s name is: ______________________________ and she/he is the Co- Petitioner herein. 10. Petitioner’s children’s name(s), age(s) and place(s) of residence are: Name:       Age:       Address:                   Name:       Age:       Address:                   Name:       Age:       Address:                   Name:       Age:       Address:                   Name:       Age:       Address:                   11. Petitioner’s name has not been previously changed, or Was previously changed as follows: Date:       Court:       Where:       12. There are: no unsatisfied money judgments presently pending against the Petitioner, or the following unsatisfied money judgments are pending against the Petitioner: Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       13. There are: no actions for money presently pending against the Petitioner, or the following actions for money are pending against the Petitioner: Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       14. The proposed change in the Petitioner’s name, if granted, will not be detrimental to the interests of any other person. 15. The Petitioner is not confined to a department of corrections facility. 16. This Petition is not filed to defraud creditors. B. 1. Petitioner’s present name is: ______________________________ . 2. Petitioner requests a change of name to: ______________________________ .. 3. That the Petitioner prays for the change of name for the following reasons: (describe in detail): ____________________________________________________________ . 4. That the Petitioner is of full legal age and is a bona fide resident of the County of ________________________ . 5. Petitioner’s date of birth: ________________________ . 6. Petitioner’s place of birth: ________________________ . 7. Petitioner’s father’s name is: ______________________________ . 8. Petitioner’s mother’s maiden is: ______________________________ . 9. Petitioner is married to the Co-Petitioner ______________________________ 10. Petitioner’s name has not been previously changed, or Was previously changed as follows: Date:       Court:       Where:       11. There are: no unsatisfied money judgments presently pending against the Petitioner, or the following unsatisfied money judgments are pending against the Petitioner: Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       12. There are: no actions for money presently pending against the Petitioner, or the following actions for money are pending against the Petitioner: Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       Court:       Case No.:       Plaintiff:       Defendant:       13. The proposed change in the Petitioner’s name, if granted, will not be detrimental to the interests of any other person. 14. The Petitioner is not confined to a department of corrections facility. 15. This Petition is not filed to defraud creditors. C. Petitioners request the Court grant the following name changes to the minor children of the Petitioners: From To                                                                         Wherefore, the Petitioner prays that, by an Order of this Court, made and entered herein, the names of Co-Petitioner’s and their minor children be changed to and decreed to be: From To Petitioners:                         Minor Children:                                                 Respectfully Submitted, ____________________________________ Signature of Petitioner ____________________________________ Signature of Petitioner Address:             Phone:       Subscribed and sworn to before me on this the       day of       , 20       . CLERK OF THE CIRCUIT COURT ________________________ or By _______________________________ Notary Public Deputy Clerk My Commission Expires: