Fill and Sign the Washington Petition Change Name Form

Petition for Change of Name – Petitioner and Family - Page 1 of 2 County District Court State of Washington In the Matter of the Petition of ) ) , ) No. _____________________________________ , ) , ) PETITION FOR CHANGE OF NAME . ) (PETITIONER & FAMILY) Yes No Petitioner(s) is /are a resident of ____________ County in the State of Washington? Yes No Petitioner(s) is/are citizens of the United States? Yes No Are you required to register as a sex offender? (If you are required to register, you shall submit a copy of this Petition to the County Sheriff and the Washington State Patrol not fewer than five days before the entry of an order granting the name change under RCW 4.24.130) If you answered yes to the above question, which family member? The person(s) whose name(s) is/are to be changed are as follows: PRESENT LEGAL NAME AGE PROPOSED NEW NAME Any child who is subject to this petition who is age 14 or older has joined in this petition. Both parents of any minor child have joined in this Petition (or) Approval of the other parent should be waived because: The petitioner(s) request the change of name for the following reasons: Petition for Change of Name – Petitioner and Family - Page 2 of 2 This petition is not made for any illegal or fraudulent purpose, and the change of name will not be detrimental to the interests of any person. I declare under penalty of perjury under the Laws of the State of Washington that the statements in this form are true and correct. Signed at , on (City & State) (Date) ________________________________Petitioner Signature ________________________________ Petitioner Signature ________________________________ Petitioner Signature ________________________________ Petitioner Signature ________________________________ Court Clerk