Fill and Sign the Name Adult Notice 101019 Reviseddocx Form

© 2017 Nevada Supreme Court Notice of Petition for Adult Name Change Your Name: ________________________ Address: ___________________________ City, State, Zip: _____________________ Phone: ____________________________ Email: ____________________________ Self-Represented Petitioner DISTRICT COURT _____________________ COUNTY, NEVADA In the Matter of the Application of: ___________________________________ (print the old name you do not want anymore) For Change of Name. CASE NO.: ____________________ DEPT: _____________________ NOTICE OF PETITION FOR CHANGE OF NAME NOTICE IS HEREBY GIVEN that a petition was filed in the above-entitled Court requesting that the Court legally change applicant’s name from (clearly print the old name you do not want anymore): _____________________ ______________________ _______________________ (first) (middle) (last) to (clearly print the name you want to be known by in the future): _____________________ ______________________ _______________________ (first) (middle) (last) The applicant submitted a statement signed under penalty of perjury that the applicant is not changing his or her name for a fraudulent purpose. NOTICE IS FURTHER GIVEN that any person objecting to the changing of applicant’s name shall file written objection with the above-entitled Court within 10 days after the publication of this Notice. DATED this (day) ______ day of (month) ___________________, 20____. Submitted By: (your signature)  _______________________________ (print your name) _______________________________