DISTRICT COURT OF THE STATE OF WASHINGTON FOR WHATCOM COUNTY, Bellingham, Washington ) ) Petition for Change of Name ) Petitioner. 1. Cause Number ____________________ ) ) In re the Matter of: I am applying for a court order which will change: My name from (Current Full Name)__________________________________________________________ First Middle Last to (New Name Desired) __________________________________________________________________ First Middle Last The name of my child or ward from __________________________________________________________ (Current Full Name) First Middle Last to (New Name Desired) ___________________________________________________________________ First Middle Last 2. 3. I reside in this judicial district. This application is made for the following reasons: 4. 5. This application is not made for any illegal or fraudulent purpose. I am not a convicted felon under supervision of the Department of Corrections, nor am I a registered sex offender. (Any such persons must follow different statutory procedures to get a change of name.) The change of name will not be detrimental to the interests of any other person(s). 6. If the name change is for a child under age 18: Both parents agree to the name change. The non-petitioning parent disagrees. The non-petitioning parent has had no contact with the child for approximately __________ years. I declare under penalty of perjury under the laws of the State of Washington that the foregoing statements in this petition are true and correct. Signed at__________________________________________________, on ________________________. (City and State) (Date) ______________________________________________________ Signature ______________________________________________________ Address ______________________________________________________ City, State, Zip ______________________________________________________ Phone Number Petition for Change of Name 08/30/2005 American LegalNet, Inc. www.USCourtForms.com