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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
PETITION FOR CHANGE OF NAME OF ADULT
TO THE HONORABLE JUDGE OF THIS COURT:Petitioner, YOUR OLD NAME, an adult, brings this suit for the change
of name, and in support of this request shows:
I.
Petitioner intends that discovery be conducted under Level 1 of the Texas Rule of
Civil Procedure 190.
II.
Petitioner's present name is YOUR OLD NAME, and Petitioner resides
at STREET, CITY, COUNTY, Texas 75200-0001.
III.
Petitioner requests that his name be changed to YOUR NEW NAME.
IV.
The reason for the requested change of Petitioner's name is that she desires to restore her maiden name.
V.
Petitioner has not had a final conviction of a felony.
VI.
1. Petitioner's present true full name is YOUR OLD NAME.
2. Petitioner is a white female.
3. Petitioner was born on _____________________________.
4. Petitioner has been issued the following driver's license:
State: Texas
Number: 12345678
Date of Issue: ______________5. Petitioner's Social Security Number is __________________.
6. Petitioner does not have any assigned FBI number, or State Identification number, or any other reference number in a criminal history record system.
7. There is no offense above the grade of a Class C misdemeanor for which the Petitioner has been charged.
8. There is no case number or Court for which a warrant was issued or a charging instrument was filed or listed for any offense above the grade of a Class C misdemeanor.
WHEREFORE, Petitioner requests that the Court find that Petitioner's change of
name is in the best interests of the Petitioner and of the public and issue an Order
changing the name of Petitioner to YOUR NEW NAME.
Respectfully submitted,
_____________________________
John Doe Smith
123 Main Street
Dallas, Texas 75200-0001
214.555.1111
Petitioner
VERIFICATION
STATE OF TEXAS
COUNTY OF ____________BEFORE ME, the undersigned Notary Public, on this day personally appeared
______________(YOUR OLD NAME), who, after being duly sworn, stated under oath that She
is the Petitioner in the above-entitled cause; that he has read the above petition, and
that every statement contained in the petition is within his personal knowledge and is
true and correct.
____________________________
YOUR OLD NAME
SUBSCRIBED AND SWORN TO BEFORE ME on ________,2004, to certify which witness my hand and official seal.
___________________________
Notary Public, State of Texas
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