Fill and Sign the Vapo Handbook Washington State Courts Form

IN THE DISTRICT COURT OF ________________ COUNTY, NEBRASKA (c ounty where Petition filed) IN RE NAME CHANGE OF CASE No.___________________ (case number assigned by Clerk of Court) _____________________. PETITION FOR NAME CHANGE (Adult) (your full name) I, ____ ___________________________, without the assistance of an attorney, (your full name) ask this Court for a name change. In support of my Petition, I state that the following items are true: 1. My address is _____________________________________________, (your present street address) _____________________, ____________________County, Nebraska. (city where you live ) (coun ty where you live) 2. I have been a resident of ____________________ County, Nebraska (county where you live ) for more than one year prior to the filing of this petition. 3. My date of birth is provided on the Confidential Party Information Form (page 3 of the Petition for Name Change). 4. My current name is _________________________________. (your current full name) 5. I desire the court to change my name of ________________________________ to ________________________________. (your current full name) (preferred new full name) Page 1 of 2 Petition for Name Change DC 6:9(1) Rev. 05/15 N ebraska State Court Form DC 6:9(1) Rev. 05/15 PETITION FOR NAME CHANGE (Adult) Neb. Rev. Stat. § 25-21, 271 6. I desire to change my name for the following reason (s):______________________________________________________________________ (list here why you desire to change your name) ______________________________________________________________________ _____________________________________________________________________. WHEREFORE, I respectfully request that the court set this matter for hearing, and that upon such hearing, order my name to be changed from _____________________________ to ____________________________________. (current full name) (preferred full name) D ate Petitioner’s Signature (your signature) Your Curren t Full Name Your Full Street Address/P.O. Box City/State/ZIP Code Phone E-mail Address Page 2 of 2 Petition for Name Change DC 6:9(1) Rev. 05/15 IN THE DISTRICT COURT OF ________________ COUNTY, NEBR ASKA ( county where Petition filed) THIS DOCUMENT IS CONFIDENTIAL AND SHALL NOT BE MADE PART OF THE COURT FILE OR PROVIDED TO THE PUBLIC PURSUANT TO NEB. CT. R. § 6-1521. IN RE NAME CHANGE OF CASE No.___________________ ( case number assigned by Clerk of Court) _ ____________________. (your full name) CONFIDENTIAL PARTY INFORMATION FORM Name Gender Birth Date Petitioner: (your current full name) Page 1 of 1 Confidential Information Form for Petition for Name Change DC 6:9(1) Rev. 05/15 N ebraska State Court Form DC 6: 9(1) Rev . 05/15 CONFIDENTIAL PARTY INFORMATION FORM FOR PETITION FOR NAME CHANGE