Petitioner's Name What is your CURRENT Name? First, middle, last New Name Are you requesting the court for an official Name Change? Are you requesting the court for an official Name Change? YesNo What is your NEW or PROPOSED Name? First, middle, last Mailing Address What is your Mailing Address? Street Address, City, State, Zip Code Gender Transition Are you requesting the court for a Gender Change? Are you requesting the court for a Gender Change? YesNo Confirm your intent to request a Gender Change. Confirm your intent to request a Gender Change. I confirm What is your new Gender Designation? SelectMaleFemaleX Do you want to provide the REASON for the Gender Change? Do you want to provide the REASON for the Gender Change? Yes (optional)No Explain the REASON for the Gender Change: Ex. "Never felt comfortable with my gender assigned at birth." Gender Change (Court Proceedings) Have you previously filed a Gender Change Petition in any court? Have you previously filed a Gender Change Petition in any court? YesNo Provide the DETAILS on the Court for the Gender Change: Date of Birth What is your CURRENT AGE? Years Old What is your Date of Birth? Place of Birth What is your Place of Birth? Include the location's Street Address, City, State, Zip Code, and Country.It is best to retrieve the hospital's mailing address where you were born and enter it here. This is to match the location mentioned on your birth certificate. Children (under 21 years old) Do you have any CHILDREN under the age of 21 years of age? Do you have any CHILDREN under the age of 21 years of age? YesNo Child Support Do you CURRENTLY pay Child Support? Do you CURRENTLY pay Child Support? YesNo What is the Child Support COLLECTIONS UNIT that governs your case? Ex. "Office of Child Support Services, New York, NY" Which COURT issued the Child Support Order? Are your Child Support Payments currently up to date? Are your Child Support Payments currently up to date? YesNo How much are you behind in Child Support? $ (estimated amount) Currently Married Are you CURRENTLY Married? Are you CURRENTLY Married? YesNo Previous Marriage Have you been PREVIOUSLY Married? Have you been PREVIOUSLY Married? YesNo Before any current marriage. Spousal Support Are you RESPONSIBLE for Spousal Support? (alimony) Are you RESPONSIBLE for Spousal Support? (alimony) YesNo Which COURT issued the Spousal Support Order? County, State Are your Spousal Support Payments up to date? Are your Spousal Support Payments up to date? YesNo If 'No', how much do you owe in Spousal Support? $ (estimated amount) Probate Office Which COUNTY is this being filed? SelectALBANYALLEGANYBRONXBROOMECATTARAUGUSCAYUGACHAUTAUQUACHEMUNGCHENANGOCLINTONCOLUMBIACORTLANDDELAWAREDUTCHESSERIEESSEXFRANKLINFULTONGENESEEGREENEHAMILTONHERKIMERJEFFERSONKINGSLEWISLIVINGSTONMADISONMONROEMONTGOMERYNASSAUNEW YORKNIAGARAONEIDAONONDAGAONTARIOORANGEORLEANSOSWEGOOTSEGOPUTNAMQUEENSRENSSELAERRICHMONDROCKLANDSARATOGASCHENECTADYSCHOHARIESCHUYLERSENECAST. LAWRENCESTEUBENSUFFOLKSULLIVANTIOGATOMPKINSULSTERWARRENWASHINGTONWAYNEWESTCHESTERWYOMINGYATESCOUNTY Which COURT TYPE is this being filed? SelectSupremeCountyNew York City CivilCourt (optional) Criminal Record Have you EVER been convicted of a crime? Have you EVER been convicted of a crime? YesNo What CRIME were your convicted of? Which COURT were you convicted? (city, state, county) Include the City, State, and County. Judgments Against You Have you EVER filed for Bankruptcy? Have you EVER filed for Bankruptcy? YesNo Are there any CURRENT Judgments or Liens of record against you? Are there any CURRENT Judgments or Liens of record against you? YesNo Are you a CURRENT PARTY to any Actions or Proceedings? Are you a CURRENT PARTY to any Actions or Proceedings? YesNo This is to ensure you are not changing your name to avoid a court proceeding. Provide DETAILS to any "Yes" above: Previous Name Changes Have you PREVIOUSLY filed a Name Change with a court? Have you PREVIOUSLY filed a Name Change with a court? YesNo Describe the DETAILS of a Name Change filed with a previous court: Request to be Sealed Do you want your court filing to be SEALED for your Personal Safety? Do you want your court filing to be SEALED for your Personal Safety? YesNo Explain the REASON for this record being sealed: Reason for Change What is the REASON for your Name Change? Ex. "Name change after marriage" or "Name change for a gender transition."The court requires an explanation of some type. Supporting Documents Will you be attaching any supporting documents to the Petition? Will you be attaching any supporting documents to the Petition? YesNo List the name and description of the supporting documents below: Next Save Save and finish later
