Petition For Change Of Name (Adult) (District II)
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Petition For Change Of Name (Adult) (District II) Form. This is a Washington form and can be use in Clallam Local County.
Tags: Petition For Change Of Name (Adult) (District II), Washington Local County, Clallam
CLALLAM COUNTY DISTRICT COURT II
STATE OF WASHINGTON
Mailing Address: 502 E Division
Forks, WA 98331
In the Matter of the Change of Name of:
PETITION FOR CHANGE OF NAME
COMES NOW _____________________and petitions the above-entitled court for an order changing
his/her name to ________________________ and shows the court as follows:
1. Petitioner was born on the ______ day of ____________________ ____________, in ____________
County, State of ______________________; is a resident of Clallam County, Washington; and is a
citizen/legal resident of the United State of America.
2. Petitioner has been known as ______________________________ for a period of ___________ and
requests this court to change his/her name to ____________________________________ for the
3. A. This petition is not made to avoid creditors or for an illegal or fraudulent purpose, but for the bona
fide purpose of changing the petitioner’s name to the name by which he/she has been and prefers
his/her name to be referred.
B. I am not under the jurisdiction of the department of corrections.
C. I am not required under RCW 9A.44.130 to register as a sex offender.
WHEREFORE, petitioner requests that his/her name be changed by order of this court from
__________________________________ to ___________________________________.
STATE OF WASHINGTON )
COUNTY OF CLALLAM )
__________________________, being first and duly sworn, upon oath, deposes and says that : I am the
petitioner above-named and I have read the foregoing Petition for change of Name, know the contents
thereof and believe the same to be true.
Subscribe and sworn to before me this ____ day of ___________________ _______.
Notary Public in and for the State of ____________
Residing in ____________________________(city)
My appointment expires:______________________
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