Dec 16, 2018 | Global Documents |
IN THE MATTER OF: Your Current Name Street Address City, State, Zip Telephone IN THE CIRCUIT COURT FOR Civil No.: FOR CHANGE OF NAME TO: New Name * * * * * * * * * * * * * * * * * * * * * PETITION FOR CHANGE OF NAME (Adult) (DOM REL 60) TO THE HONORABLE, THE JUDGE OF SAID COURT: Your Current Name My name has been changed to the following since birth for the following reasons: (List any reasons why your name may have changed since birth, for example, marriage). Name Changed To: Reason: I have attached any documents that changed my name officially. DR 60 (Rev. 9/2005) Page 1 of 2 Petitioner, , respectfully represents to this Court: 1. That I was born on , in , Your Birthdate Your Birthplace - City, State, County and presently reside at Present Address 2. That I was born Your Birth Name attached birth certificate.) . (See copy of 3. Select one of the following: I have never registered as a sexual offender; OR I am or have previously been registered as a sexual offender under the following name: 4. I am requesting this change of name because: 5. I wish to change my name to: . Full Name as Registered New Name 6. I hereby certify that the above change of name is not requested for any illegal or fraudulent purposes. WHEREFORE, I respectfully request that the Court pass an Order changing my name from to . Current Name New Name I, , solemnly affirm under the penalties of perjury, that the contents of the foregoing paper are true to the best of my knowledge, information and belief. DR 60 (Rev. 9/2005) Page 2 of 2 Your Current Name Date Your Signature Your Name - Printed Address City, State, Zip Telephone
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