CLALLAM COUNTY DISTRICT COURT II STATE OF WASHINGTON Mailing Address: 502 E Division Forks, WA 98331 360-374-6383 In the Matter of the Change of Name of: NO. ______________________________________, PETITION FOR CHANGE OF NAME (MINOR) Minor Child _____________________________________________, By Guardian (Petitioner) COMES NOW _____________________as guardian of minor child ________________________ and petitions the above-entitled court for and order changing minor child’s name to _____________________ and shows the court as follows: 1. Minor child 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. Minor child has been known as ______________________________ for a period of ___________ and requests this court to change his/her name to ____________________________________ for the reason that: 3. This petition is in the best interest of the minor child and not made for any illegal or fraudulent purpose, but for the bona fide purpose of changing the minor child’s name to the name by which he/she has been and prefers his/her name to be referred. WHEREFORE, petitioner requests that minor child’s name be changed by order of this court from __________________________________ to ___________________________________. ______________________________________ Petitioner STATE OF WASHINGTON ) ) ss. 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. ______________________________________ Petitioner Subscribe and sworn to before me this ____ day of ___________________ _______. ______________________________________ Notary Public in and for the State of ____________ Residing in ____________________________(city) My appointment expires:______________________ American LegalNet, Inc. www.USCourtForms.com