Petition For Change Of Name
ADVERTISEMENT
1IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE THIRD JUDICIAL DISTRICT
In the Matter of the Change of Name of:
)
)
_______________________________________________ )
Case No: _____________
(Present Full Name)
Petitioner
)
)
PETITION FOR
to:_____________________________________________ )
CHANGE OF NAME
(Proposed New Name)
)
1.
I, _________________________________________petitioner, request a judgment
changing my name as set forth in the title of this petition.
2.
I am age 18 or older and I reside in Marion County.
3.
My date of birth is:
___________________
4.
I am requesting this name change because: _____________________________________
______________________________________________________________________________
______________________________________________________________________________
I hereby declare that the above statement is true to the best of my knowledge and belief, and that
I understand it is made for use as evidence in court and is subject to penalty for perjury.
_______________________________
Petitioner
Subscribed and Sworn to before me this _____ day of _____________, 20_____.
_______________________________________________
Clerk/Notary/Judge My commission expires:__________
Submitted by:
_____________________________________________________________________________
Attorney/Petitioner’s Name
Address
_____________________________________________________________________________
City
State Zip
Phone No.
If Attorney:
Bar No.
E-mail
Fax
Certificate of Document Preparation
If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all
boxes and complete all blanks that apply)
A. G
I selected this document for myself, and I completed it without paid assistance.
B. G
I paid or will pay money to _________________ for assistance in preparing this form/document
__________________________
Signature
PETITION FOR CHANGE OF NAME – Page 1 of 1
FC (2/23/12)(Form 1)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal