Fill and Sign the State of Alabama Probate Court Jefferson Form

1 STATE OF ALABAMA PROBATE COURT JEFFERSON COUNTY CASE NO._________________ PETITION FOR CHANGE OF NAME TO: HONORABLE ALAN L. KING, JUDGE OF PROBATE and HONORABLE SHERRI C. FRIDAY, JUDGE OF PROBATE AND DEPUTY PROBATE JUDGE ELIZABETH NORTH: NOW COMES, __________________________________________, whose date of birth is ____/_____/______whose Driver’s License/Non-Driver’s License ID number is____________________ from the State of _____________and Social Security number is _________________________________ and respectfully shows to the Court that he/she is over the age of nineteen years and is a bona fide resident of Jefferson County, State of Alabama , whose address is: ____________________________________________________________________________________ (Street address only; no P.O. boxes) City State Zip WHEREFORE, in accord with the statues of the State of Alabama, the petitioner files this declaration in writing, signed by him/her, requesting his/her name be changed as follows: (Choose one) 1) (Name on birth record, if never married) Name changed from:_________________________________________________________ To: ______________________________________________, due to the following reason(s): ______________________________________________________________________ ______________________________________________________________________; OR: 2) (Married Name) Name changed from:_____________________________________________________ To: ______________________________________________, due to the following reason(s): _____________________________________________________________________ ____________________________________________________________________; OR: 3) (Other Reason) Name changed from:______________________________________________________ To: ______________________________________________, due to the following reason(s): _____________________________________________________________________ _____________________________________________________________________. 2 Your petitioner further states and declares under penalty of perjury under the laws of the State of Alabama: that the foregoing is true and correct: Initial each correct statement: _______That a true and correct copy of my birth certificate has been filed along with this petition; _______That he/she has never been convicted as a Criminal Sex Offender; as provided by Act 98-489; _______That he/she is not currently a party to any judicial proceeding in any court in any jurisdiction; _______That he/she is not currently a defendant to any criminal charge; _______That he/she is not attempting to avoid payment of any debt or judgment of debt; _______That he/she is not attempting to commit fraud in any manner whatsoever; _______That he/she has never been convicted of any felony or crime involving moral turpitude; _______That he/she authorizes a criminal background check prior to the name change being granted; Your petitioner prays that the Court will make such order in the premises as may be proper to change his/her name as prayed. DATED:______________________ __________________________________ Petitioners Signature Address:__________________________ __________________________________ Home Phone # (205)_________________ Work/Cell Phone # (205)______________ NOTARY ACKNOWLEDGEMENT STATE OF ALABAMA JEFFERSON COUNTY I, _______________________________, a Notary Public in and for said County, in said State, hereby certify that _______________________________________ whose name is signed to the foregoing NAME CHANGE PETITION and who is known to me, acknowledged before me, on this day, that, being informed of the contents of this conveyance, he/she, has executed the same voluntarily, on the day the same bears date. Given under my hand, this the _________day of _____________, 20____. _____________________________________ Notary Public My commission expires:_________________