Petition For Change Of Name Form. This is a Oregon form and can be use in Marion Local County.
Tags: Petition For Change Of Name, 1, Oregon Local County, Marion
IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE THIRD JUDICIAL DISTRICT In the Matter of the Change of Name of: ) ) _______________________________________________ ) (Present Full Name) Petitioner ) ) to:_____________________________________________ ) (Proposed New Name) ) 1. Case No: _____________ PETITION FOR CHANGE OF NAME I, _________________________________________petitioner, request a judgment changing my name as set forth in the title of this petition. 2. 3. 4. I am age 18 or older and I reside in Marion County. My date of birth is: ___________________ I am requesting this name change because: _____________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is made for use as evidence in court and is subject to penalty for perjury. _______________________________ Petitioner Subscribed and Sworn to before me this _____ day of _____________, 20_____. _______________________________________________ Clerk/Notary/Judge My commission expires:__________ Submitted by: _____________________________________________________________________________ Attorney/Petitioner's Name Address _____________________________________________________________________________ City State Zip Phone No. If Attorney: Bar No. E-mail Fax Certificate of Document Preparation If this document was not completed by an attorney, I hereby certify that the following statements are true: (check all boxes and complete all blanks that apply) A. G I selected this document for myself, and I completed it without paid assistance. B. G I paid or will pay money to _________________ for assistance in preparing this form/document __________________________ Signature PETITION FOR CHANGE OF NAME Page 1 of 1 FC (2/23/12)(Form 1)