____________________________________
Full Name of Party Filing This Document
Mailing Address (Street or Post Office Box)
City, State and Zip Code
Telephone Number
IN THE DISTRICT COURT FOR THE JUDICIAL DISTRICT OF
THE STATE OF IDAHO AND IN FOR THE COUNTY OF
|
IN
RE:
___________________________________,
|
Case No.: ___________________
PETITION FOR NAME CHANGE
(Adult)
Fee Category: ____________
Filing Fee: ____________
|
STATE OF IDAHO )
) ss.
County of )
I swear under oath:
- My full legal name and current residence are listed
above.
- I was born on ____,
in the city of _______________________________, County of ,
State of _________________________.
3. a.
[ ] My father is living. or
[
] My father is not living and the names and addresses of his closest
blood relatives are: _________________________________________
.
b. [
] My mother is living. or
[
] My mother is not living and the
names and addresses of her closest blood relatives are: ____________ ____________________________________________________________________.
4.
I want to change my name to ______
because _____ .
5. The name change is not to avoid
creditors or outstanding debts. I am not required to register as a convicted
sexual offender under Chapter 83, Title 18, Idaho Code, or under the provisions
of similar laws enacted by another state.
WHEREFORE, I ask that
a Deputy Clerk of the Court issue a Notice of Hearing in this case to be
published for four (4) successive weeks in the ______________________________
_______________________a newspaper printed in this County; the matter be heard,
with the Court examining me under oath; and the Judge sign an Order changing my
name as I have asked.
Date:
By: _____________________________
Signature Typed/Printed Name of Party
SUBSCRIBED
AND SWORN to before me on this day of__________, 20____.
Notary Public for Idaho
Residing
at:
My
Commission expires:
