22-02E (11/13) Petition for Name Change (ACP) FORM 1 IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MULTNOMAH In the Matter of the Change of Name of: Case No: Your Present Name Last, First, Middle Petitioner PETITION FOR NAME CHANGE to (ACP ) Your New Name Last, First, Middle I request that my name be changed from: to Your present name Last, First, Middle . I chose this form for myself and completed it without paid help. A legal help organization helped me choose or complete this form, but I did not pay money to anyone. I paid(or will pay) for help choosing, completing, or reviewing this form. Date Signature Name (printed) Contact Address City, State, ZIP Contact Phone American LegalNet, Inc. www.FormsWorkFlow.com