King County District Court State of Washington South Division, Vashon Branch In the Matter of the Petition of __________________________________, __________________________________, __________________________________, __________________________________. Yes Yes 1 Yes No No No ) ) ) ) ) ) No. _____________________________________ PETITION FOR CHANGE OF NAME (PETITIONER & FAMILY) Petitioner(s) is /are a resident of King County in the State of Washington? Petitioner(s) is/are citizens of the United States? Are you required to register as a sex offender? (If you are required to register, you shall submit a copy of this Petition to the King County Sheriff and the Washington State Patrol not fewer than five days before the entry of an order granting the name change under RCW 4.24.130) If you answered yes to the above question, which family member? _________________________________________________________ The person(s) whose name(s) is/are to be changed are as follows: PRESENT LEGAL NAME AGE ___________________________ ___________________________ ___________________________ ___________________________ _______ _______ _______ _______ PROPOSED NEW NAME _____________________________ _____________________________ ______________________________ ______________________________ Any child who is subject to this petition who is age 14 or older has joined in this petition. Both parents of any minor child have joined in this Petition (or) Approval of the other parent should be waived because:_________________________________________________________________________________________ The petitioner(s) request the change of name for the following reasons: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ This petition is not made for any illegal or fraudulent purpose, and the change of name will not be detrimental to the interests of any person. I declare under penalty of perjury under the Laws of the State of Washington that the statements in this form are true and correct. Signed at __________________________________________, on _______________________ (City & State) (Date) _____________________________________________ Petitioner Signature __________________________________ Petitioner Signature __________________________________ Petitioner Signature __________________________________ Petitioner Signature __________________________________ Court Clerk KCDCF # 64c/01 American LegalNet, Inc. www.USCourtForms.com