Name Change Petition

The name change is for:

The name change is for: a married person who wants to include a name change for their spouse and/or minor child(ren).an adult only.a minor only.

The name change is for the following reason:

Maximum of 80 characters.

What is the current name of the person who wants to change their name?

Does the petitioner wish to include a name change for their spouse?

Does the petitioner wish to include a name change for their spouse? YesNo

Does the petitioner wish to include a name change for their minor child(ren)?

Does the petitioner wish to include a name change for their minor child(ren)? YesNo

Name of Parent 1:

Is Parent 1 deceased?

Is Parent 1 deceased? YesNo

Name of Parent 2:

Is Parent 2 deceased?

Is Parent 2 deceased? YesNo

Name of minor's guardian:

If this does not apply, leave blank.

Guardian of a mentally incompetent parent:

If this does not apply, leave blank.

Both parents of the minor consent jointly to the name change.

Both parents of the minor consent jointly to the name change. YesNo

The minor's sole surviving parent consents to the name change.

The minor's sole surviving parent consents to the name change. YesNo

The minor's only available parent consents to the name change (only if that parent has legal custody).

The minor's only available parent consents to the name change (only if that parent has legal custody). YesNo

The guardian of the minor consents to the name change.

The guardian of the minor consents to the name change. YesNo

The guardian of a parent who has been declared mentally incompetent consents to the name change.

The guardian of a parent who has been declared mentally incompetent consents to the name change. YesNo

Is one of the minor's parents noncustodial?

Is one of the minor's parents noncustodial? Yes, only one parent has custody.No, both parents have custody.

Does the parent without custody agree to the name change?

Does the parent without custody agree to the name change? Yes, the parent without custody agrees to the minor's name change.No, the parent without custody has not agreed to the minor's name change.

Has the parent without custody been able to visit, contact, and communicate with the minor(s) and has failed or neglected to do so for a period of two years or more before the filing of this petition?

For the parent without custody:

For the parent without custody: A court has ordered support and the parent has failed to comply for two years or more before filing this petition.A court has not ordered support but the parent has failed to support the minor(s) for two years or more before filing this petition.Neither statement applies.

Has the parent without custody been convicted of child abuse, criminal sexual conduct, or assault with intent to commit criminal sexual conduct where the minor(s) or a sibling of the minor(s) was the victim?

Has the parent without custody been convicted of first degree murder or second degree murder?

Has the parent without custody been convicted of first degree murder or second degree murder? YesNo

Petitioners Name:

Address:

City, State, and Zip Code:

Telephone Number:

The petitioner

The petitioner does not have a criminal record.has a criminal record (including any pending charges).

Specify the petitioner's criminal record, including any pending charges:

Maximum 120 characters. Include additional sheets if necessary.

The petitioner's spouse and/or minor children:

The petitioner's spouse and/or minor children: do not have any criminal record.have a known criminal record (including any pending charges).

Specify their criminal record, including any pending charges:

Max 120 characters. Include additional sheets if necessary.

Does the petitioner have an attorney for this matter?

Does the petitioner have an attorney for this matter? YesNo

Attorney's Name and Bar Number:

Address:

City, State, and Zip Code:

Telephone Number:

Does this petition have an existing case number or judge's name?

Does this petition have an existing case number or judge's name? YesNo

Name of the judge this petition is made to:

Case number for this petition:

Has an action been previously filed within the jurisdiction of the family circuit court involving the family or family members of the petitioner?

Has an action been previously filed within the jurisdiction of the family circuit court involving the family or family members of the petitioner? Yes, an action has been filed previously.No such action has been filed previously.

In which court was the action filed?

Which judge was it assigned to?

What is/was the Case Number?

Is this action still pending?

Is this action still pending? The action remains pending.The action is no longer pending.

The petitioner's current name is:

First Name:

Middle Name:

Last Name:

The petitioner would like their name changed to:

First Name:

Middle Name:

Last Name:

The spouse's current name is:

First Name:

Middle Name:

Last Name:

The spouse would like to their name changed to:

First Name:

Middle Name:

Last Name:

How many minors are included in this petition?

How many minors are included in this petition? 12

For additional minors, please complete another form.

Minor 1 current name is:

First Name:

Middle Name:

Last Name:

Minor 1 would like their name changed to:

First Name:

Middle Name:

Last Name:

Minor 2 current name is:

First Name:

Middle Name:

Last Name:

Minor 2 would like their name changed to:

First Name:

Middle Name:

Last Name:

In which county will the application be made?

Address of the court where this application will be made:

Telephone number of the court where this application will be made:

Are you requesting that names on new birth certificates are hidden, and original birth certificates are sealed?

Are you requesting that names on new birth certificates are hidden, and original birth certificates are sealed? YesNo

I request that the following name(s) NOT be disclosed on the new birth certificate:

Save and finish later

Michigan Name Change Petition

The petitioner's current name is:

The petitioner would like their name changed to:

The spouse's current name is:

The spouse would like to their name changed to:

Minor 1 current name is:

Minor 1 would like their name changed to:

Minor 2 current name is:

Minor 2 would like their name changed to: