SUPERIOR COURT OF FULTON COUNTY STATE OF GEORGIA In re the Name Change of Child(ren): Civil Action Case Number v. Petitioner, , Respondent. , PETITION TO CHANGE NAME(S) OF MINOR CHILD(REN) My name is and I am representing myself in this petition. In support of my case, I state the following: 1. 2. I reside in Fulton County, Georgia. Therefore, jurisdiction and venue are proper in this Court. My relationship to the child(ren) in this action is: [Check only one below.] __ Mother __ Father 3. __ Guardian The current names, birthdates and proposed new names of the child(ren) are: Current Name of Child Year of Birth Proposed New Name Petition to Change Name(s) of Minor Child(ren) -- Rev. October 2015 Provided by the Fulton Family Law Clinic American LegalNet, Inc. www.FormsWorkFlow.com Current Name of Child Year of Birth Proposed New Name 4. [Check only one of the following.] __ (a) The children live with me in Fulton County, Georgia. __ (b) The children do not live with me. They live with Georgia. in County, 5. [Explain here why you want to change the name(s).] The reasons for this name change are as follows: 6. The mother of the children is , her address is , and she: [Check only one of the following.] _ (a) Has consented to this name change and has acknowledged service; the signed consent and acknowledgement of service shall be filed with this Petition to Change Name(s) of Minor Child(ren) -- Rev. October 2015 Provided by the Fulton Family Law Clinic American LegalNet, Inc. www.FormsWorkFlow.com Petition. __ (b) Is deceased. __ (c) Has abandoned the child(ren). __ (d) Has not contributed to the support of the child(ren) for a continuous period of at least 5 years immediately preceding the filing of this Petition. 7. The father of the children is , , and he: [You must check only one of the following.] __ (a) Has consented to this name change and has acknowledged service; the signed consent and acknowledgement of service shall be filed with this Petition. __ (b) Is deceased. __ (c) Has abandoned the child(ren). __ (d) Has not contributed to the support of the child(ren) for a continuous period of at least 5 years immediately preceding the filing of this Petition. 8. [You must check one (and only one) of the following.] __ (a) There is no legal guardian for these children, other than their parent(s). __ (b) Both parents are deceased or have abandoned the child(ren), and the guardian of the child(ren) is address is , and she or he has consented to this name change and has acknowledged service; the signed consent and acknowledgement of service shall be filed with this Petition. THEREFORE, the Petitioner asks: (a) That the name(s) of the child(ren) be changed to the names shown in Paragraph 3 of the petition; , whose his address is Petition to Change Name(s) of Minor Child(ren) -- Rev. October 2015 Provided by the Fulton Family Law Clinic American LegalNet, Inc. www.FormsWorkFlow.com (b) That Respondent(s) be served with notice of this Petition as provided by law; [Check one of the following methods of service for each person who must be served.] _ (c) _ (d) _ (e) That the __ mother __ father __ person acting as guardian of the minor children be personally served; That the __mother __ father __ person acting as guardian of the minor children be served by certified mail, because they reside outside the state of Georgia; That the Court order service by publication for the __ mother __ father __ person acting as guardian of the minor children, whose address is unknown. Dated: Petitioner, Pro se (Signature) Name: Address: Phone (day): ( ) Petition to Change Name(s) of Minor Child(ren) - Rev. October 2015 Provided by the Fulton Family Law Clinic American LegalNet, Inc. www.FormsWorkFlow.com