Petitioner's Name What is your CURRENT name? First, Middle, Last New Name What is your NEW or PROPOSED name? First, Middle, Last Mailing Address What is your STREET ADDRESS? In which County do you reside? Reason for Change What is the REASON for the name change? Provide a brief description of the reason for requesting this name change petition. For example, "I am requesting this name change after my divorce." Year of Birth What is the YEAR of your birth? Enter the year only. Birthplace In which COUNTY were you born? County of In which STATE were you born? State of Criminal History Have you ever been convicted of a criminal offense involving fraud, forgery, or violence? Have you ever been convicted of a criminal offense involving fraud, forgery, or violence? YesNo Select "Yes" if you are currently the defendant in a criminal proceeding involving fraud, forgery, or violence but have yet to be convicted or dissolved. Explain the circumstances regarding the criminal offense: Petitioner's Contact Details What is your telephone number? County In which COUNTY will this petition being filed? Please write the county in ALL CAPS. For example, "FULTON" or "GWINNETT." Notarization Required Do you understand that this Name Change Petition must be NOTARIZED? Do you understand that this Name Change Petition must be NOTARIZED? Yes, I understand Next Save Save and finish later
