Fill and Sign the Petition for Change of Name Indiana Form

State of Indiana County of ______________________________ In The ____________________________________________________________ Court In Re the Petition of:       )       )       )       )       )       ) CASE NO.       ) For a Change of Name to: ) )       )       )       )       )       )       ) ) PETITION FOR NAME CHANGE COMES PETITIONER(S): ____________________________________ and ____________________________________ by this petition, and upon being duly sworn, respectfully represents and shows unto the Court: A. 1. That the Petitioner is of full legal age and is a bona fide resident of the County of ________________________ , State of Indiana, whose residence address is ____________________________________________________________ . Petitioner has been a bona fide resident of ________________________ County, State of Indiana for ____________ years immediately prior to filing this Petition. Petitioner was born on the ______ day of ____________ , ______ , in the County of ________________________ , State of ________________________ . 2. Petitioner’s present name is ____________________________________ . This is the current name of Petitioner on his social security card and all other records. - 1 - 3. Petitioner is (check one) not married or is married to ____________________________________ . 4. Petitioner (check one) owns no real estate or owns real estate in ________________________ County, ________________________ . B. 5. That the Petitioner is of full legal age and is a bona fide resident of the County of ________________________ , State of Indiana, whose residence address is ____________________________________________________________ . Petitioner has been a bona fide resident of ________________________ County, State of Indiana for ____________ years immediately prior to filing this Petition. Petitioner was born on the ______ day of ____________ , ______ , in the County of ________________________ , State of ________________________ . 6. Petitioner’s present name is ____________________________________ . This is the current name of Petitioner on his social security card and all other records. 7. Petitioner is (check one) not married or is married to ____________________________________ . 8. Petitioner (check one) owns no real estate or owns real estate in ________________________ County, ________________________ . C. 9. Petitioner’s children’s name(s), age(s) and place(s) of residence are: Name:       Age:       Address:                   Name:       Age:       Address:                   Name:       Age:       - 2 - Address:                   Name:       Age:       Address:                   Name:       Age:       Address:                   7. That the Petitioner(s) pray(s) for the change of names for the following reasons: (describe in detail):       8. That the proposed change in the Petitioner’s name, if granted, will not be detrimental to the interests of any other person and is not against the public interest. 9. That Petitioner is not confined to a department of correction facility. This Petition is not filed to defraud creditors. 10. Petitioners request the Court grant the following name changes for the Petitioner(s) and the minor children of the Petitioners: From To                         - 3 -                         Wherefore, the Petitioner(s) pray(s) that by an Order of this Court, made and entered herein, the Petitioner(s)’ and the minor children of the Petitioner(s)’ names be changed to and decreed to be: From To                                                             Respectfully Submitted, ______________________________ Signature Address:             Phone:       ______________________________ Signature Address:             Phone:       - 4 - 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 ______________________________ - 5 -