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Petition For Change Of Name (Minor) Form. This is a Tennessee form and can be use in Shelby Local County.
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Tags: Petition For Change Of Name (Minor), Tennessee Local County, Shelby
IN THE CIRCUIT COURT OF TENNESSEE FOR THE
THIRTIETH JUDICIAL DISTRICT AT MEMPHIS
IN THE MATTER OF:
Natural Mother/Father and next friend of
Docket Number:
Petitioner
PETITION FOR CHANGE OF NAME
TO THE HONORABLE JUDGES OF THE CIRCUIT COURT OF SHELBY COUNTY, TENNESSEE:
Comes now your Petitioners
,natural Mother or Father
and next friend of
, a minor in the above styled and
numbered cause, and files this Petition requesting change of name and for cause of action would show
unto the Court the following facts, to wit:
1.
That your Petitioner is a minor resident, citizen of
, Shelby County, Tennessee.
2.
Your Petitioners would further show unto the Court said minor child was born in
County,
on
, and whose name appears as
on his/her birth certificate.
3.
That your Petitioner respectfully requests of this Honorable Court that he/she be able to
change the minor's name to
4.
.
Your Petitioners herein states that he/she is not a felon or criminal and that the reasons
for the name change are personal and that he/she does not seek to change their name in
order to avoid or evade any debts or obligations as he/she is not indebted to anyone in
any significant amount, and that they do not request this change of name for any illegal
purpose.
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WHEREFORE, PREMISES CONSIDERED, YOUR PETITIONER PRAYS
1.
That upon hearing of this cause, the court orders the legal change of the name of the
minor child to
2.
.
For all other relief, both general and special, to which they may be entitled in the
premises.
______________________________________
Natural Mother or Father and Next Friend of
(Signature)
______________________________________
A Minor Petitioner (Signature)
STATE OF TENNESSEE
COUNTY OF SHELBY
I, ___________________________________________, being first duly sworn according to law, state
that the contents herein are true to the best of my knowledge, information and belief.
______________________________________
Natural Mother or Father and Next Friend of
(Signature)
______________________________________
A Minor Petitioner (Signature)
Sworn and subscribed before me this ________ day of ____________________________, 20______
My Commission Expires:
______________________________________
Notary/Deputy Clerk
_______________________
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STATE OF TENNESSEE
COUNTY OF SHELBY
AFFIDAVIT FOR NAME CHANGE
The undersigned, having petitioned to change his/her name, hereby makes oath, as required by
T.C.A. ยง 29-8-101 (B) that:
1.
I have never been convicted of First or Second Degree Murder.
2.
I have never been convicted of any offense which requires a sexual offender to register
pursuant to the "Sexual Offender Registration and Monitoring Act" found in Tennessee
Code Annotated, Title 40, Chapter 39.
_____________________________________
Natural Mother or Father and Next Friend of
(Signature)
_____________________________________
A Minor Petitioner (Signature)
Sworn and subscribed before me this ___________ day of ________________________, 20_____
My Commission Expires:
_____________________________________
Notary/Deputy Clerk
_______________________
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IN THE CIRCUIT COURT OF TENNESSEE FOR THE
THIRTIETH JUDICIAL DISCTRICT AT MEMPHIS
IN THE MATTER OF:
Natural Mother or Father and next friend of
Docket Number:
Petitioner
ORDER ALLOWING CHANGE OF NAME
This cause came to be heard on this date upon the sworn Petition of
, Mother or Father and Next Friend of
, a minor, upon their respective testimony in
open court, and upon the entire record in this cause.
It appearing to the Court from all of the above that said minor was born in
County on
presently a resident of
and is
, Shelby County, Tennessee and that Petitioner for good and sufficient
cause desires to change his/her name to
and that the change should be officially noted on the Petitioner's birth certificate.
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the name of
be and is hereby changed to
and that their name be officially shown and
designated hereafter for all legal purposes as such and that a copy of this Order be furnished to
appropriate State and County agencies to effectuate the purpose of this Order for Name Change.
_______________________________
Petitioner (Signature)
_______________________________
JUDGE
_______________________________
Date
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