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Fill and Sign the Petition for Adult Family Name Change Oregon Form

Fill and Sign the Petition for Adult Family Name Change Oregon Form

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IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR __________ COUNTY PROBATE DEPARTMENT In the Matter of the Change of Name of: ) )       ) Case No.: ____________ ) (Present Name of Petitioner) ) ) PETITION FOR CHANGE OF NAME )       To: )       )       ) ) (Proposed New Name) ) A. I, ______________________________ , petitioner, request a decree changing my name as set forth in the title of this petition. B. I am age 18 or older and I reside in _______________________ County. C. I am requesting this name change because:                   _______________________________ Petitioner STATE OF OREGON ) ) ss. County of ____________ ) I, _______________ , being first duly sworn, do hereby declare and say that I am the petitioner in this case; I have read this petition and know its contents, and I believe it to be true. _______________________________ Petitioner SIGNED AND SWORN to before me on ___________________. __________________________________ Court Clerk/Notary Public for the State of Oregon My commission expires: ______________ Submitted by:       Attorney/Petitioner’s Name Bar No. (if any)       Address       City State Zip Phone No.       Trial Attorney if other than above Bar No. Certificate of Document Preparation If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply) A. selected this document for myself, and I completed it without paid assistance. B. I paid or will pay money to __________________ for assistance in preparing this form/document. __________________________ Signature

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