Inmate Affidavit For Name Change
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Inmate Affidavit For Name Change Form. This is a Minnesota form and can be use in District Court Statewide.
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Tags: Inmate Affidavit For Name Change, NAM-105, Minnesota Statewide, District Court
State of Minnesota County Judicial District: Court File Number: Case Type: District Court Name Change In the Matter of the Application of: First Middle Last For a change of name to: Inmate Affidavit for Name Change (Minn. Stat. § 259.12) Last First Middle STATE OF MINNESOTA COUNTY OF ) ) SS ) I, statement: , the applicant in this matter, make the following I am currently an inmate confined in a correctional facility, as defined in section 241.021, subdivision 1(f). I have not at any time during my confinement requested a name change under section 259.10, other than this request. The reason I am seeking a name change is: I request the court to issue its Order Granting Name Change. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. § 358.116. Dated: Signature Name: Address: City/State/Zip: Telephone: ( E-mail address: ) American LegalNet, Inc. www.FormsWorkFlow.com NAM105 State ENG Rev 7/15 www.mncourts.gov/forms Page 1 of 1
