Verified Petition For Name Change
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Verified Petition For Name Change Form. This is a Indiana form and can be use in Family Law (Pro-Se) Statewide.
Tags: Verified Petition For Name Change, Indiana Statewide, Family Law (Pro-Se)
STATE OF INDIANA
COUNTY OF (Select One)
IN THE (Select One)
IN RE THE NAME CHANGE OF: )
VERIFIED PETITION FOR CHANGE OF NAME
Petitioner, ___________________________________________________________, pro se,
respectfully petitions this Court to change his/her name. In support of this Petition, Petitioner states as
That my current name is: _______________________________________________________.
That I reside at:
That pursuant to Indiana Code 34-28-2-1, I wish to change my name.
That I am not seeking to defraud creditors by changing my name.
That I have not been convicted of a felony within the last ten (10) years.
That I am not a sex or violent offender who is required to register under IC 11-8-8.
That I wish to change my name to: ________________________________________________.
WHEREFORE, I respectfully request that this Court grant my Petition for Name Change, and for
all other just and proper relief. I affirm under the penalties of perjury that the foregoing representations
Approved by State Court Administration 02/10
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