What is your CURRENT Name? First Name Middle Name Last Name What is your NEW or PROPOSED Name? First Name Middle Name Last Name What is your Street Address? Street Address (only) Apt # City/Town State 2-letter abbreviation Zip Code Mailing Address Do you have a Mailing Address that is DIFFERENT from your Street Address? Do you have a Mailing Address that is DIFFERENT from your Street Address? YesNo For the mailing of court documents and legal notices. If not, your Street Address will be used. Street Address (only) Apt # City/Town State 2-letter abbreviation Zip Code Reason for Change What was the REASON for the change? Ex. "Name change after marriage" or "As part of a gender change." Date of Birth What is your Date of Birth? Mother's Maiden Name What is your Mother's Maiden Name? Petitioner's Contact Details What is your Phone Number? What is your Email Address? Former Name Have you ever LEGALLY changed your name in the past? Have you ever LEGALLY changed your name in the past? YesNo What was your FORMER name? First, middle, last What was it CHANGED to? If this is your current name, then enter it here. Have you ever gone by any OTHER names or aliases in the past? Have you ever gone by any OTHER names or aliases in the past? YesNo List any other names or aliases you have used in the past: Photo ID If there is a COURT HEARING, would you like a language interpreter? If there is a COURT HEARING, would you like a language interpreter? YesNo What LANGUAGE would you prefer at a hearing? Ex. Spanish Court Which COUNTY is this being filed? SelectBarnstableBerkshireBristolDukesEssexFranklinHampdenHampshireMiddlesexNantucketNorfolkPlymouthSuffolkWorcesterCounty This should be the same county where you reside. Certified Copies Would you like to request CERTIFIED COPIES of all documents filed with the court? Would you like to request CERTIFIED COPIES of all documents filed with the court? YesNo If yes, it is sent by first-class mail. Last 4 of SSN What are the Last 4 Digits of your Social Security Number? ______-____- Certified Documents A certified copy of your birth certificate and any certified copies of any prior name change (i.e., marriage certificate, divorce decree, court order changing name) must be filed with this petition. A certified copy of your birth certificate and any certified copies of any prior name change (i.e., marriage certificate, divorce decree, court order changing name) must be filed with this petition. I understand Next Save Save and finish later
