REV 4/1/19 JCB 1 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( Minor222s current legal name you wish to change ) Code: 3490 First Parent222s: Name: Address: Telephone: Email: Second Parent222s: Name: Address: Telephone: Email: Self-Represented Litigants IN THE FAMILY DIVISION OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE In the Matter of the Change of Name of: . Case No. Dept. No. A Minor. / PETITION FOR MINOR NAME CHANGE We petition this Court as follows: We are the parents of the above-named minor child.We consent to the child222s name change.We are not seeking a name change for any illegal or fraudulent purpose. American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 2 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( city ) ( state ) ( When the minor moved to Washoe County ) 4. The child is resident of Washoe County and intends to continue to reside in Washoe County. The child has been a resident since . 5. The child was born on // in , . 6. (a) The addresses, person(s) with whom the child lived with, and their relationship to the child is as follows for the last five years: Date Child Moved Here Address Person(s) With Whom Child Lived The Person(s) Relationship to Child / / / / / / / / (b) Please identify any other court case in which you have participated as a party, witness, or in any other way concerning the custody of or visitation with the child. If there are no other court cases, please check this box . Court: Case number: Date of custody determination: (c) Please identify any court case that could affect this case, including any case relating to domestic violence, protective orders, termination of parental rights, adoptions, guardianships, dependency, and paternity actions. If there are no other court cases, please check this box . Court: Type of case: Case number: Date of last order: American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 3 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( current first) ( current middle ) ( current last ) ( desired last ) ( desire d middle ) ( desired first) ( Amount of time child has used legal name ) (d) Please identify the name(s) and address(es) of any person(s) not a party to this court case who claim(s) a right to legal custody, physical custody, or visitation with the child. If this is not applicable, please check this box . Name(s) and address(es) of person(s) claiming custody or visitation rights: 7. The child IS 226OR226 IS NOT 14 years of age or older. If they are, a separate consent HAS 226OR226 HAS NOT been filled out by the child. 8. The current address of the First Petitioning Parent is: The mailing address of the First Petitioning Parent is ( Check one): SAME AS ABOVE 226OR226 OTHER: The current address of the Second Petitioning Parent is: The mailing address of the Second Petitioning Parent is ( Check one): SAME AS ABOVE 226OR226 OTHER: 9. We wish to change the child222s name from: to: 10. The child has used their current name for American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 4 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 11. We originally agreed on the minor222s current name. 226OR226 The minor222s current name was chosen without the consent of both parents. 12. The child222s name should be changed because: If more room is needed, attach additional sheets. Explain, in detail, 1) why you want the change the child222s name, and 2) how the name change is in the best interests of the child. American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 5 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( Name child goes by, if different than current legal name ) 13. The child goes by their current name. 226OR226 The child goes by 14. Changing the child222s name WILL 226OR226 WILL NOT cause insecurity or identity confusion. If it will, explain: 15. The name change WILL 226OR226 WILL NOT change the child222s name to be the same as other family members. If it will, please identify the family members: 16. The name change IS 226OR226 IS NOT being requested for cultural reasons. If it is, explain: 17. The child WILL 226OR226 WILL NOT suffer any embarrassment, discomfort, or inconvenience by the name change. If they will, explain: American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 6 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 18. The child222s relationship with the First Petitioning Parent will be impacted by the name change in the following way(s): 19. The child222s relationship with the Second Petitioning Parent will be impacted by the name change in the following way(s): 20. The child HAS 226OR226 HAS NOT been convicted of a felony. If the child has been convicted of a felony, state the date of conviction, the County and State of conviction, the offenses, and the final sentence: If more room is needed, attach additional sheets. This document does not contain the personal information of any person as defined by NRS 603A.040. We declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. Date: First Parent222s Signature: First Parent222s Name: Date: Second Parent222s Signature: Second Parent222s Name: American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 7 NM-1 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 VERIFICATION I, (first parent222s name) , declare that I am a Petitioner in the above-entitled action; that I have read the foregoing Petition and know the contents thereof; that the pleading is true of my own knowledge, except for those matters therein contained stated upon information and belief, and that to those matters, I believe them to be true. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. FIRST PARENT222S SIGNATURE I, (second parent222s name) , declare that I am a Petitioner in the above-entitled action; that I have read the foregoing Petition and know the contents thereof; that the pleading is true of my own knowledge, except for those matters therein contained stated upon information and belief, and that to those matters, I believe them to be true. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. SECOND PARENT222S SIGNATURE American LegalNet, Inc. www.FormsWorkFlow.com