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Petition For Name Change (Minor Under 18) Form. This is a Virginia form and can be use in Prince William Local County.
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Tags: Petition For Name Change (Minor Under 18), Virginia Local County, Prince William
* * * THIS IS A SAMPLE ONLY AND NOT TO BE USED AS A FILL IN THE
BLANK FORM. DO NOT retype the language in the parenthesis ( ) when you
retype this form. The information in each paragraph needs to be changed as
necessary for your particular case. This form is NOT intended to be legal advice
and should NOT be relied upon as such. You are encouraged to consult Virginia
Code §8.01-217. * * *
V I R G I N I A:
IN THE CIRCUIT COURT OF PRINCE WILLIAM COUNTY
IN RE: NAME CHANGE
FROM: _____________________
(Current name of child)
TO:
_____________________
(New name of child)
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CL No. _________________
PETITION FOR NAME CHANGE
COMES NOW your Petitioner(s), ___________________________ and
____________________ (parent(s) names), and after being duly sworn, state under oath
in support of [their/his/her] (choose only ONE) Petition to change the name of the minor
child ____________________ (child’s current name) to _______________________
(child’s new name), as follows:
1. That the name of the minor child’s father is _______________________, and
the name of the minor child’s mother is _____________________________, and the
maiden name of the minor child’s mother is ____________________________.
2. That the minor child was born to the Petitioner(s) on the ____ day of
_____________, 19___, in the city and state of ________________________.
3. That the minor child resides with [his/her] (choose only ONE) parent(s) at
_________________ (address the child lives at).
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4. That the minor child has no felony conviction record, is not presently
incarcerated, or on probation in any court.
5(a).
The minor child’s name has not been changed before.
5(b).
The minor child’s name has previously been changed from
______________ (list any names you have asked the Court to change the child’s name
from in the past).
(Choose either # 5(a) OR #5(b) – NOT BOTH. Renumbered as #5).
6. Petitioner(s) do not ask to change the minor child’s name for any illegal or
fraudulent purpose, or to infringe upon the rights of others, but because ____________
_____________________________________________________________________
(state why you are asking to change the child’s name).
WHEREFORE, your Petitioner(s) prays that the name of the minor child
__________________ (child’s current name) be changed to __________________
(child’s new name).
[WE/I] (choose only ONE) ASK FOR THIS:
___________________________ (Signature)
Typed name of Petitioner
Type your complete address
Type your phone number
___________________________ (Signature)
Typed name of Co-Petitioner (if any)
Type your complete address
Type your phone number
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STATE OF VIRGINIA,
COUNTY OF PRINCE WILLIAM, to wit:
I ____________________________________, a Notary Public/Deputy Clerk in and for
the County of _____________________________, Virginia, do hereby certify that on the
_____ day of ____________________, 20_____, _______________________________
(Petitioner #1) and _____________________________ (Petitioner #2, if any) personally
appeared before me and subscribed and swore to the foregoing statement as being true
and accurate to the best of his/her knowledge and belief.
Given under my hand this _____ day of ____________________, 20____.
My commission expires _________________________________, 20____.
___________________________________
Notary Public/Deputy Clerk
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