Current Name What is your FIRST Name? What is your MIDDLE Name? What is your LAST Name? New Name What is your new or proposed FIRST Name? What is your new or proposed MIDDLE Name? What is your new or proposed LAST Name? County of Residence What county do you live in? SELECTADAMSBARNESBENSONBILLINGSBOTTINEAUBOWMANBURKEBURLEIGHCASSCAVALIERDICKEYDIVIDEDUNNEDDYEMMONSFOSTERGOLDEN VALLEYGRAND FORKSGRANTGRIGGSHETTINGERKIDDERLAMOURELOGANMCHENRYMCINTOSHMCKENZIEMCLEANMERCERMORTONMOUNTRAILNELSONOLIVERPEMBINAPIERCERAMSEYRANSOMRENVILLERICHLANDROLETTESARGENTSHERIDANSIOUXSLOPESTARKSTEELESTUTSMANTOWNERTRAILLWALSHWARDWELLSWILLIAMSCOUNTY This will also be the same county where you will file your name change. When did you become a resident of this county? To file, you must be a resident for at least 6 months. North Dakota Residency How long have you been a resident of North Dakota? Year(s) Month(s) Mailing Address What is your street address? City: State: Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming ZIP Code: U.S. Citizenship What is your citizenship status? What is your citizenship status? I am a U.S. citizenI am a permanent resident alien Birth Year In what year were you born? Place of Birth Where were you born? Ex. Fargo, North Dakota, USA Petitioner's Contact Details This is strictly for the court's use. What is your email? What is your phone number? Reason for Name Change Why are you changing your name? Ex. "Name change after marriage" or "As part of a gender transition." Newspaper Publication Have you announced your new name in the newspaper? Have you announced your new name in the newspaper? YesI am requesting to waive this requirement This is required before filing the Name Change Petition in the county court. Which newspaper published your name change announcement? When was your announcement published in the newspaper? Enter the FIRST DATE it was published. Reason for Waiver Why are you requesting to waive the newspaper publishing requirement? Why are you requesting to waive the newspaper publishing requirement? I am only requesting a change of my first or middle nameI am a victim of domestic violence or abuse If you're asking the court to waive the publication requirement due to domestic violence, please add details about the situation: Required by the court Will you be attaching a separate document to this petition describing reasons for the waiver request? Will you be attaching a separate document to this petition describing reasons for the waiver request? YesNo Objections Were any written objections submitted to your name change announcement? Were any written objections submitted to your name change announcement? Yes (must attach to petition)No List each objector's name and their relation to you: Criminal History Have you ever been convicted of a crime? Have you ever been convicted of a crime? YesNo What was the conviction? Class of Crime: Classes of Crimes are: AA, A, B, and C. What is the name of the court that convicted you? In what year did the incident occur? Do you have another conviction to list? Do you have another conviction to list? YesNo What was the second conviction? Class of Crime: What is the name of the court that convicted you? In what year did the incident occur? Do you have another conviction to list? Do you have another conviction to list? YesNo What was the third conviction? Class of Crime: What is the name of the court that convicted you? In what year did the incident occur? Do you have another conviction to list? Do you have another conviction to list? YesNo What was the fourth conviction? Class of Crime: What is the name of the court that convicted you? In what year did the incident occur? Do you have another conviction to list? Do you have another conviction to list? YesNo What was the fifth conviction? Class of Crime: What is the name of the court that convicted you? In what year did the incident occur? Do you have another conviction to list? Do you have another conviction to list? YesNo What was the sixth conviction? Class of Crime: What is the name of the court that convicted you? In what year did the incident occur? Will you be attaching additional convictions to your petition? Will you be attaching additional convictions to your petition? YesNo Required if you have more than six convictions. Next Save Save and finish later
