Fill and Sign the North Carolina Name Adult Form

STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE SUPERIOR COURT DIVISION COUNTY OF       Before the Clerk SP FROM: )       ) ) PETITION FOR CHANGE OF NAME ) TO: )       ) NOW COMES ______________________________ resident of __________________ County, North Carolina and respectfully petitions the Court for an Order to be issued changing his/her name and to that end does hereby state and show unto the court: 1. The true name as shown on my birth certificate is ______________________________ . 2. The date of birth was ______ day of __________________ , 19 ______ . In the County of __________________ , State of __________________ . 3. The parents full names are: (father) ______________________________ and (mother) ______________________________ as shown on the birth certificate. 4. The name desired to adopt is ______________________________ . 5. I desire the change for the following reason: ________________________________________________________________________ 6. I have given 10 days notice of my intent to file this Petition by posting it on the courthouse bulletin on ________________________ . 7. My name has never been changed pursuant to NCGS 101.6. This the ______ day of __________________ , 20 ______ . ____________________________________ Full Name of Petitioner       Print or Type Name Subscribed and sworn before me This ______ day of __________________ , 20 ______ ____________________________________ Notary Public My Commission expires: __________________