Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Seeking A Legal Name Change - Macomb County Package Form. This is a Michigan form and can be use in Macomb Local County.
Loading PDF...
Tags: Seeking A Legal Name Change - Macomb County Package, Michigan Local County, Macomb
Seeking a Legal Name Change?
For a legal name change, it is necessary to open a court case within the family division of the circuit court.
The filing fee to open a case is $150. You must be a resident of Macomb County for at least one year prior to
filing for a legal name change. For minors that are not yet one year old, the parent or legal guardian must
be a Macomb County resident for one year prior to filing for a legal name change. The forms necessary to
open a name change case can be obtained from our office or from the State Court Administrator’s Office
website at http://courts.michigan.gov. All other forms listed are available through our office.
In order to open the case, along with the fee, you will need to complete the “Petition to Change Name” form
and “Publication of Notice of Hearing” form and present all to the court section of the Macomb County
Clerk’s Office. The Petition must be filled out in its entirety. For the “Publication of Notice of Hearing”
form leave the hearing date, time, and judge blank. The whole process takes approximately 2 months.
After the case is opened:
For Adults 22 years of age or older:
If the petitioner seeking a legal name change is 22 years of age or older, fingerprinting is required. Fingerprinting must be
done AFTER your case is opened. You can have fingerprints taken at your local police agency for which you may be
charged a fee. After the fingerprints are completed, it is necessary to mail them to the Michigan State Police with a $49.25
processing fee (we have a form you will be given upon opening your case that contains the address and other information on
fingerprinting called “Special Instructions for Name Change”). Since we are unable to give you a hearing date until
fingerprint results have been received, it is necessary to furnish our office with a self-addressed, stamped envelope upon case
initiation so we may mail you the notice of your hearing date. The case proceeds as listed below under “For All Instances”
For Adults over the age of 18 but less than 22 years of age:
No fingerprinting is necessary. The case proceeds as listed below under “For All Instances”.
For Minors (Any Child under the age of 18):
A copy of the child’s birth certificate needs to be filed prior to the hearing date. If a legal name change is sought on behalf of
a minor, both parents can petition the court by both signing the Petition for Name Change upon case initiation. Otherwise,
one parent may initiate proceedings to seek a legal name change but will either need the consent of the other parent (the form
for this is called “Waiver/Consent”) or it will be necessary to properly serve the other parent with the paperwork (the form
for this is called “Proof of Service”). This needs to be completed even if the father’s name is not listed on the birth
certificate. If you are unable to locate the other parent, the “Affidavit of Diligent Search” form will need to be filled out. If
the non-custodial parent has not made support payments for 2-years but has been ordered to do so, the form “Change of
Name of Minor Notice of Child Support Payments” is submitted to the Friend of the Court to complete. This can be used
in lieu of service to the other parent only where the non-custodial parent is ordered to pay support but has not within the
previous 2 years. The Waiver/Consent, Proof of Service, Affidavit of Diligent Search, or Notice of Child Support payments
must be filed prior to the hearing date. No fingerprinting is necessary for minors. The case proceeds as listed below under
“For All Instances”.
For All Instances:
A hearing date is set by the court once fingerprint results are received (for those over 22-this is mailed to you) or upon case
initiation (for those who are a minor or between the ages of 18 and 21who do not need to have fingerprints taken). The
hearing date is set 8 weeks out by way of the “Publication of Notice of Hearing” form. The notice of publication is also
sent to the Legal News for publishing. ALL name changes must be published. The fee for publication is $71.30 and you will
be billed for this directly from the Legal News. This fee must be paid prior to your hearing date. You then appear on your
hearing date and time. If the judge assigned to your case grants the name change an order granting the legal name change is
signed. You will then be directed to the court section of the clerk’s office to receive your certified copy. A certified copy is
necessary to have your name changed at various agencies (i.e.-Secretary of State, School, etc.). The cost for a certified copy
of a name change order is $12.00 ($10 for the certification and $1 per page of the document – a name change order is a 2page document).
Rev. 01/08
American LegalNet, Inc.
www.FormsWorkFlow.com
Circuit Court ORI
MI-500015J
CARMELLA SABAUGH
Clerk of 16th Judicial Circuit Court
Family Division
40 North Main, Mount Clemens, MI 48043
586-469-5208
SPECIAL INSTRUCTIONS FOR NAME CHANGE
Every person 22 years of age or older whose name appears on the "Petition to Change Name"
must follow these instructions before the court can act on the petition.
Pursuant to Michigan law, every person 22 years of age or older who is requesting a name change
must have a complete set of fingerprints taken at a local police agency. Those fingerprints will be
used by the Michigan State Police and Federal Bureau of Investigation to check criminal records. The
Michigan State Police will send a report to the court regarding any criminal records.
If you have a criminal record, it will be presumed that you are seeking the name change with
fraudulent intent. You must prove to the court that the name change is not being sought with
fraudulent intent.
INSTRUCTIONS:
1. File the "Petition to Change Name" (form PC 51) with the circuit court and pay the filing fee.
2. Make one copy of the completed "Petition to Change Name" (form PC 51).
3. Go to your local police agency for the fingerprint card and to have your fingerprints taken. The
police agency will advise you of the appropriate fee. Take a copy of the "Petition to Change Name"
with you.
4. After you have had your fingerprints taken, mail the copy of the "Petition to Change Name," the
fingerprint card, and the appropriate fee which is currently $49.25, to the Michigan State Police. The
fee must be made payable to the State of Michigan. Mail to:
Michigan State Police
Criminal Records Division
P O BOX 30634
Lansing, Michigan 48913
5. The Michigan State Police will review your criminal records and will forward the fingerprints to the
Federal Bureau of Investigation. Once the Federal Bureau of Investigation has reviewed its records
and reported the information to the Michigan State Police, the Michigan State Police will send a report
to the court.
6. After the court receives the required report from the Michigan State Police, the court can schedule
a hearing on the "Petition to Change Name."
o The court will mail you a notice when the required report is received. You must give the court a
preaddressed, postage-paid envelope for mailing this notice.
o Contact the court eight weeks after you mail or deliver your fingerprint card to the Michigan
State Police to find out if the required report has been received.
rev. 9/08 SPECIAL INSTRUCTIONS NAME CHANGE
American LegalNet, Inc.
www.FormsWorkFlow.com
OSM CODE: NAM
Approved, SCAO
FILE NO.
STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY
In the matter of the name change of
to
PETITION TO CHANGE NAME
Present first name(s), middle name(s), and last name(s) (type or print)
Requested new first name(s), middle name(s), and last name(s) (type or print)
1. An action within the jurisdiction of the family division of circuit court involving the family or family members of the above named
person(s) has been previously filed in
Court, Case Number
, was
assigned to Judge
, and
remains
2. The name change is for:
a. a married person who wishes to also include a name change for:
his/her spouse.
his/her minor child(ren), of whom the petitioner has legal custody.
b. an adult.
c. a minor, whose natural or adopted parents are:
is no longer
pending.
and
Mother
.
Father
Both parents are deceased. The guardian is
Name
.
(attach letters of guardianship)
3. The name change is for the following reason:
4. The name change is not sought for any fraudulent intent.
5. The following person(s) seeking a name change have a criminal record:
6. Each person for whom a name change is sought has been a resident of the county for at least one year.
[Complete item 7. only if the name change is for a minor. Please see other side for remainder of petition.]
7. I have legal custody of the minor.
a. The noncustodial parent has had the ability to visit, contact, or communicate with the child and has regularly and
substantially failed or neglected to do so for a period of two years or more before the filing of this petition and either:
a support order has been entered, and the noncustodial parent has failed to substantially comply with the order for
a period of two years or more before the filing of this petition; or
a support order has not been entered and the noncustodial parent, having the ability to support or assist in supporting
the child, has failed or neglected to provide regular and substantial support for two years or more before the filing of
this petition.
b. The noncustodial parent has been convicted of child abuse (MCL 750.136b), criminal sexual conduct (MCL 750.520b,
MCL 750.520c, 750.520d, or 750.520e), or assault with intent to commit criminal sexual conduct (MCL 750.520g) and the child or
a sibling of the child was the victim. (attach judgment of sentence)
c. The last known address of the noncustodial parent is:
The noncustodial parent is not living at the above address, and I have taken the following steps to locate him/her:
(PLEASE SEE OTHER SIDE)
Do not write below this line - For court use only
PC 51 (9/03)
PETITION TO CHANGE NAME
MCL 333.2872, MCL 711.1, MCR 3.613
American LegalNet, Inc.
www.FormsWorkFlow.com
8. I request the following name change(s):
(type or print first name, middle name, and last name)
FROM
TO
DATE OF BIRTH
Petitioner
month, day, year
Spouse
month, day, year
Minor child
Minor child
Minor child
Minor child
If you want a new live birth certificate, check item 9. A special order is not needed if you only want to add the changed name(s) to the original certificate(s).
9. I request the court to order the State Registrar to create a new live birth certificate that does not disclose the name of
at birth and to seal the original certificate.
Name
I declare that this petition has been examined by me and that its contents are true to the best of my information, knowledge,
and belief.
Date
Date
Petitioner signature
Petitioner signature
Name (type or print)
Name (type or print)
Address
Address
City, state, zip
Telephone no.
Telephone no.
City, state, zip
10. I am the spouse of the petitioner or the non-custodial parent of the minor and consent to the granting of this petition to change
name.
Signature
Date
11. I am a minor 14 years of age or older, and I consent to the granting of this petition to change my name.
Date
Minor's signature
Date
Minor's signature
12. I am a minor under 14 years of age, and I state my preference to the name change above.
Date
Minor's signature
Date
Minor's signature
Attorney signature
Address
Attorney name (type or print)
Bar no.
City, state, zip
Telephone no.
American LegalNet, Inc.
www.FormsWorkFlow.com
American LegalNet, Inc.
www.FormsWorkFlow.com
American LegalNet, Inc.
www.FormsWorkFlow.com
STATE OF MICHIGAN
COUNTY OF MACOMB
CIRCUIT COURT- FAMILY DIVISION
RE:
MINOR NAME CHANGE
AFFIDAVIT OF
DILIGENT SEARCH
CASE NO.
____________________________________________________________________________________
The undersigned being duly sworn says that service of a Notice of
Hearing cannot be made on the non-custodial parent,____________________________________________
(name)
(last known address)
The whereabouts of the person has not been determined, and that the affiant has made diligent
inquiry to ascertain the present address of the above named
individual; that such inquiry has been unsuccessful; and consisted of the
following:
Inquired of known relatives or acquaintances (list date, name,
address, telephone for each)
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Telephone Book
Known Employees
School
Police Department
State Department of Social Services
Friend of the Court
Credit Bureau
City & County Directory
Department of Corrections
County Clerk
___ Other _________________________________________________________________
I declare that this affidavit has been examined by me and that its contents are true to the
best of my knowledge and belief.
Affiant’s Signature:_____________________________ Date:____________________
SUBSCRIBED AND SWORN BEFORE ME ON:_________________.
IN_______________________COUNTY,_________________________.
SIGNATURE:_______________________________________________.
Notary Public
PRINT:____________________________________________________.
MY COMMISSION EXPIRES:________________________________.
(6/03)
American LegalNet, Inc.
www.FormsWorkFlow.com
40 North Main Street
Mt. Clemens, MI 48043
(586) 469-5208
CHANGE OF NAME OF MINOR
NOTICE OF CHILD SUPPORT PAYMENTS
Father’s Name:
Social Security Number:
Mother’s Name:
Social Security Number:
Child’s Name:
Social Security Number:
Date of Birth:
Return to:
(Name of Petitioner)
(Address)
(City, State, Zip Code)
(Telephone Number)
TO BE COMPLETED BY FRIEND OF THE COURT
Date of Child Support Order:
Amount of Child Support Ordered:
Date of Last Child Support Payment:
Amount of Last Child Support Payment:
Total Arrearage:
As of
Date:
Approved by Friend of the Court
American LegalNet, Inc.
www.FormsWorkFlow.com
American LegalNet, Inc.
www.FormsWorkFlow.com