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CAUSE NO. ___________
IN THE DISTRICT COURT _____ JUDICIAL DISTRICT
IN RE:
YOUR CURRENT NAME
PETITIONER, AN ADULT
NAME OF YOUR COUNTY
STATE OF TEXAS
DECREE GRANTING NAME CHANGE
On ___________, 2004, this Court heard the application of Petitioner JOHN DOE
SMITH for a decree changing his name. Petitioner appeared in person.
The Court, having considered the verified pleadings, and having heard the
evidence presented, finds the following:
1. The present name and place of residence of the Petitioner is:
_________________________________________________________________
2. The full name requested for the Petitioner is NEW NAME.
3. The Petitioner is a white female, born _________; Texas Driver's License Number
___________issued _________; Social Security Number ____________.
4. There is no assigned FBI number, State identification number, nor any other
reference number in a criminal history record system that identifies the Petitioner;
nor is there any offense above the grade of a Class C Misdemeanor charged against
this Petitioner.
5. The Petitioner does not have a final felony conviction.
6. The change of name is in the interest of, or to the benefit of the Petitioner, and is in
the interest of the public.
7. The Court Orders that the change of name granted in this Order, pursuant to
§45.104 of the Texas Family Code, does not release the Petitioner from liability
incurred in Petitioner's previous name, nor does it defeat any right of the Petitioner
in the Petitioner's previous name.
IT IS THEREFORE, ORDERED, that the name of OLD NAMEis changed to NEW NAME.
SIGNED on _______________, 2004.
___________________________
JUDGE PRESIDING
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