Fill and Sign the Petition Change Minor Form

 County Court  District Court  Denver Juvenile Court _________________________________ County, Colorado Court Address: In the Matter of the Petition of: Parent(s)/Petitioner(s): for: Minor Child: to change the child’s name to: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom PETITION FOR CHANGE OF NAME (MINOR CHILD) 1. Information regarding the minor child : Full Name of Minor Child (First, Middle and Last) Mailing Address Date of Birth 2. The minor child is a resident of County, Colorado. 3. I/We______________________________________________ wish to change the name of the minor child to __________________________________ ________________ ___________________________________. First Name Middle Name Last Name My/Our relationship to the child is ___________________________________________________________. 4. The proposed change would be proper and not detrimental to the interests of any other person and in the best interest of the minor child . 5. The reason for the change of name is _________ 6. The child  is  is not the subject of a child support, allocation of parental responsibilities, or parenting time action. If so, please identify (case number), (type of case) and (name of Court). 7.  The minor child (if 14 years of age or older), has not been adjudicated as a juvenile delinquent for an offense that would constitute a felony if committed by an adult in this state or any other state or under federal law. The fingerprint- based criminal history record check for the minor child is attached as Exhibit A and is conducted within 90 days prior to the filing of this Petition . 8. The required notice to the non-custodial parent has been accomplished by:  notice (JDF 422 )  consent (JDF 423) or  request to publish (JDF 424) and is filed with this petition  Not Applicable (There is no non-custodial parent) I/We, _____________________________ swear/affirm under oath that I have read the foregoing Petition and that the statements contained in this Petition are true to the best of my knowledge and belief. JDF 421 R3-18 PETITION FOR CHANGE OF NAME (MINOR CHILD)  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. VERIFICATION AND ACKNOWLEDGEMENT I swear/affirm under oath that I have read the foregoing Petition and that the statements set forth therein are true and correct to the best of my knowledge. ___________________________________ ______________________________________ (Printed name of Petitioner ) Signature of Petitioner ________________________________________________________________________________________ Petitioner’s Address City State Zip Code ________________________________________________________________________________________ (Area Code) Home Telephone Number Area Code) Work Telephone Number ____________________________________________________________________________________________________ Signed and sworn to before me by _________________________________________in the County of _______________________, State of __________________, this _______, day of ________________, 20 ____. My Commission Expires: ___________________ _____________________________________ Deputy Clerk/Notary Public __________________________________________________________________________________________ I swear/affirm under oath that I have read the foregoing Petition and that the statements set forth therein are true and correct to the best of my knowledge. ___________________________________ _______________________________________ (Printed name of Co-Petitioner) Signature of Co-Petitioner ________________________________________________________________________________________ Co-Petitioner’s Address City State Zip Code ________________________________________________________________________________________ (Area Code) Home Telephone Number Area Code) Work Telephone Number Signed and sworn to before me by _________________________________________in the County of _______________________, State of __________________, this _______, day of ________________, 20 ____. My Commission Expires: ___________________ _____________________________________ Deputy Clerk/Notary Public JDF 421 R3-18 PETITION FOR CHANGE OF NAME (MINOR CHILD)