CURRENT Name What is your current FIRST Name? What is your current MIDDLE name? What is your current LAST name? NEW or REQUESTED Name What is your new FIRST Name? What is your new MIDDLE Name? What is your new LAST Name? County Which COUNTY is this being filed? SELECTBAKERBENTONCLACKAMASCLATSOPCOLUMBIACOOSCROOKCURRYDESCHUTESDOUGLASGILLIAMGRANTHARNEYHOOD RIVERJACKSONJEFFERSONJOSEPHINEKLAMATHLAKELANELINCOLNLINNMALHEURMARIONMORROWMULTNOMAHPOLKSHERMANTILLAMOOKUMATILLAUNIONWALLOWAWASCOWASHINGTONWHEELERWHEELERYAMHILLCOUNTY This should be the same county where you reside. Your Address What is your Street Address (only) What is your City, State, and Zip Code? Gender Change Are you changing your GENDER? Are you changing your GENDER? YesNo Confirm your request to legally change your Gender: Confirm your request to legally change your Gender: I confirm What is your NEW GENDER? What is your NEW GENDER? MaleFemaleNonbinary Confirm your Gender selection: Confirm your Gender selection: I confirm Child Support Do you owe child support or current ordered to pay child support? Do you owe child support or current ordered to pay child support? YesNo Explain the Child Support: (include the State and Case Number) Protective Order Do you current have a protective order, stalking order, or restraining order against you? Do you current have a protective order, stalking order, or restraining order against you? YesNo Explain the Order: (include the State and Case Number) Probation Are you currently on probation, parole, or under post-prison supervision? Are you currently on probation, parole, or under post-prison supervision? YesNo Explain the Conditions: Sex Offender Are you required to register as a sex offender? Are you required to register as a sex offender? YesNo Explain the Reason for being labeled a Sex Offender: Former Names Have you ever LEGALLY used another name? Have you ever LEGALLY used another name? YesNo Enter a Former Name (1) Add another Former Name? Add another Former Name? YesNo Enter a Former Name (2) Add another Former Name? Add another Former Name? YesNo Enter a Former Name (3) Add another Former Name? Add another Former Name? YesNo Enter a Former Name (4) Add another Former Name? Add another Former Name? YesNo Enter a Former Name (5) Add another Former Name? Add another Former Name? YesNo Enter a Former Name (6) Sealed Record Do you want this Name Change Record to be sealed? Do you want this Name Change Record to be sealed? YesNo What is the reason? What is the reason? I am a participant in the Address Confidentiality Program under ORS 192.826.I am requesting a Change of Sex and I want the record to be sealed. Contact What is your Phone Number? This is for the use of the court only. Next Save Save and finish later
