Before you complete this petition, you should read the Instructions for Filing on the next page. You must answer all questions and check all boxes that apply to you on this petition. You must file this petition in the superior court of the county where the person whose name is to be changed resides.is 18 years old or olderPetitioner requests a decree recognizing that the petitioner222s gender is changed to:a.b.Petitioner requests that the court order that a new birth certificate be issued reflecting the gender and name changes sought by this petition.Petitioner requests that the court issue an order directing any interested persons to file written objections to show cause why the petition for change of name should not be granted.Petitioner provides the following information in support of this petition:a.The declaration below.The information contained in the attachment (attach a completed copy of the attachment Name and Information About the Person Whose Name Is to Be Changed (form NC-110)).Page 1 of 2PETITION FOR CHANGE OF NAME, RECOGNITION OF CHANGE OF GENDER, AND ISSUANCE OF NEW BIRTH CERTIFICATEForm Adopted for Mandatory Use Judicial Council of California NC-200 [Rev. September 1, 2018] Code of Civil Procedure, 247 1275 et seq.; Health and Safety Code, 247247 103430, 103435 www.courts.ca.gov1.3.4.5.6.b226f.(Instructions on next page)Petitioner (present name): female. male.nonbinary. 2. PETITION OF (name): CASE NUMBER: PETITION FOR CHANGE OF NAME, RECOGNITION OF CHANGE OF GENDER, AND ISSUANCE OF NEW BIRTH CERTIFICATENC-200 SUPERIOR COURT OF CALIFORNIA, COUNTY OFSTREET ADDRESS:MAILING ADDRESS:CITY AND ZIP CODE:BRANCH NAME: ATTORNEY OR PARTY WITHOUT ATTORNEYSTATE BAR NUMBER:NAME:FIRM NAME:STREET ADDRESS:CITY:STATE:ZIP CODE:TELEPHONE NO.:FAX NO.:E-MAIL ADDRESS:ATTORNEY FOR (name):Petitioner requests that the court decree that petitioner222s name is changed, in order to conform to petitioner's gender identity, to c. I declare under penalty of perjury under the laws of the state of California that the request for a change in gender to (check one) is to conform my legal gender to my gender identity and is not for any fraudulent purpose. female nonbinary male Date: (TYPE OR PRINT NAME OF PETITIONER)(SIGNATURE OF PETITIONER) (present name):DECLARATION and a resident of this county.(proposed name): American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR FILING A PETITION FOR CHANGE OF NAME AND GENDERWhere to File The petition for change of name and gender must be filed in the superior court in the county where the petitioner is a resident.1.2.Whose Name May Be ChangedThe petition may be used to change your name and to obtain a court order recognizing a change of gender and for issuance of anew birth certificate, if you are 18 or older. (Minors must use form NC-500.) If you were born in California, you may file the orderwith the State Registrar and obtain a new birth certificate.3.Petition for Change of Name, Recognition of Change of Gender, and Issuance of New Birth Certificate (form NC-200) Order to Show Cause for Change of Name to Conform to Gender Identity (form NC-125/NC-225)Decree Changing Name and Order Recognizing Change of Gender Identity and for Issuance of New Birth Certificate (form NC-230) Court HearingIf no objections are filed, the court will grant the petition without a hearing. A hearing date will be set if timely objections have beenfiled. If there is a hearing, you will be sent a notice by the court. You may also check with the court after the deadline to see if ahearing date has been set. Bring copies of all documents to the hearing. If the judge grants the name and gender change petition,the judge will sign the original decree.Birth CertificateIf you were born in California, to obtain a new birth certificate reflecting the change of gender, file a certified copy of the order within30 days with the Secretary of State and the State Registrar and pay the applicable fees. You may write or contact the StateRegistrar at: Local courts may supplement these instructions. Check with the court to determine whether supplemental information is available. For instance, the court may provide you with additional written information identifying the department that handles name and gender change petitions, and the times when petitions are heard.NC-200 [Rev. September 1, 2018]Page 2 of 2What Forms Are Required You need an original and two copies of each of the following documents:a.b.Name and Information About the Person Whose Name Is to Be Changed (Attachment to Petition) (form NC-110)c.d.4.Filing and Filing FeePrepare an original Civil Case Cover Sheet (form CM-010). File the original petition and Civil Case Cover Sheet with the clerk ofthe court and obtain two filed-endorsed copies of the petition. A filing fee will be charged unless you qualify for a fee waiver. (If youwant to apply for a fee waiver, see Request to Waive Court Fees (form FW-001) and Information Sheet on Waiver of SuperiorCourt Fees and Costs (form FW-001226INFO).)5.Filing the Order to Show CauseAsk the court clerk to obtain a judge222s signature on the Order to Show Cause, then file the original order in the clerk222s office andobtain filed-endorsed copies of the order.6.Domestic Violence Confidentiality ProgramIn cases where the petitioner is a participant in the state address confidentiality program (Safe at Home), the petition, the order toshow cause, and the decree should, instead of giving the proposed name, indicate that the name is confidential and on file with theSecretary of State. See Information Sheet for Name Change Proceedings Under Address Confidentiality Program (Safe at Home)(form NC-400-INFO).7.8.PETITION FOR CHANGE OF NAME, RECOGNITION OF CHANGE OF GENDER, AND ISSUANCE OF NEW BIRTH CERTIFICATE California Department of Public Health Vital Records 226 MS 5103 P.O. Box 997410 Sacramento, CA 95899-7410Phone: 916-445-2684 Website: www.cdph.ca.govCivil Case Cover Sheet (form CM-010)e.NC-200 American LegalNet, Inc. www.FormsWorkFlow.com