Free NAME CHANGE FOR A MINOR CHILD - Arizona

NAME CHANGE FOR A MINOR CHILD

PINAL COUNTY
TO MAKE A REQUEST FOR A CHANGE OF NAME FOR A MINOR CHILD
INSTRUCTIONS AND FORMS
Provided as a Public Service by Kristi Youtsey Ruiz Clerk of the Superior Court
PINAL COUNTY
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED Change of Name for Minor Use only most current version

CLERK OF SUPERIOR COURT SELF SERVICE CENTER

APPLICATION FOR CHANGE OF NAME OF A MINOR CHILD
CHECKLIST

USE THE FORMS AND INSTRUCTIONS in this packet only if the following factors apply to your situation:



You want to ask the court to change the name of a minor child, AND



You are the parent or guardian of the child,

NOTE: For information regarding name changes that can be obtained without going to court,
or to add a name to, or change a name on a birth certificate, please contact the Arizona Department of Health Services, Bureau of Vital Records at (602) 364-1237.

READ ME: It is very important for you to know that when you sign a court document, you
may be helping or hurting your court case. Before you sign any court document, or get involved with a court case, it is important that you see a lawyer to make sure you are doing the right thing.

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version

PINAL COUNTY CLERK OF SUPERIOR COURT SELF SERVICE CENTER PROCEDURES: HOW TO FILE FOR A CHANGE OF NAME WITH THIS COURT FOR A MINOR CHILD STEP 1:
FILL OUT THE FORMS: Use Black Ink Only. Keep Forms Neat & Clean. Do Not Fold Forms. Do Not Use Line Paper When Including Attachments Fill out the "Application for Change of Name for a Minor Child", "Civil Cover Sheet" and the "Notice of Hearing Regarding Application for Change of Name" (leave date, time and location blank).

STEP 2: STEP 3:

MAKE COPIES: Make 2 copies of the "Application for Change of Name for a Minor Child" FILE THE PAPERS AT THE COURT: WHO: Who must file the "Application for Name Change of a Minor Child"? The Parent of Guardian of that child, or the attorney of the Parent or Guardian, must file the papers. GO TO: GO TO THE CLERK OF COURT TO FILE YOUR PAPERS: The Court is open from 8am-5pm, Monday-Friday. You should go to the Court at least two hours before it closes. You may file your court papers at the following Superior Court locations: Clerk of Superior Court 820 E. Cottonwood Ln Bldg B Casa Grande, AZ 85122 (520) 836-1073

FLORENCE: Clerk of Superior Court CASA GRANDE: 971 Jason Lopez Circle Bldg A Florence, AZ 85132 (520) 866-5300 MAMMOTH: Clerk of Superior Court 118 Catalina County Complex Mammoth, AZ 85618 (520) 487-2928 FEES:

APACHE JUNCTION: Clerk of Superior Court 575 N. Idaho Road Suite 109 Apache Junction, AZ 85119 (480) 982-4166

Please check with the Clerk's office for the current filing fee. The fee is payable to the Clerk of the Superior Court by cash, money order, visa or mastercard or personal check with proper identification. If the filing fee is a hardship and you think a fee deferral is appropriate, ask the staff at the Customer Service Counter for an Application for Fee Deferral before you file your Petition. Note: With the Application for Deferral, you must provide proof of income (copy of your last 2 most recent paystubs)

PAPERS: Give your original application and all copies to the Clerk along with the filing fee. Make sure the filing clerk conforms (stamps) all of your copies and returns them to you.

STEP 4:

SCHEDULE YOUR HEARING AT THE TIME OF FILING: After filing your application, the clerk will complete the "Notice of Hearing Regarding Application for Change of Name" to show the date (depending on your method of service), time, and place of your hearing. You must request copies of this form.
Change of Name for Minor Use only most current version

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

STEP 5:

NOTIFY ANY INTERESTED PARTY: WHO: You must notify the other parent of the minor child, or both parents if you are the child's guardian, about your request for name change and the scheduled hearing. If the child is 14 years or older, they must sign a notarized consent to the name change request, or attend the hearing. HOW TO NOTIFY: If you know where your person(s) lives, you can do one of the following: 1. IF THE PARENT(S) AGREES WITH YOUR REQUEST ­ Give each parent a stamped copy of your application and the "Notice of Hearing Regarding Application for Change of Name" that shows the date, time, and place of your hearing. Then, have the parent(s) complete the form entitled, "Consent of Parent to Name Change of a Minor Child and Waiver of Notice" and have it notarized. That document serves as your proof of notice. Bring the signed and notarized "Consent of Parent to Name Change of a Minor Child and Waiver of Notice" to the hearing. 2. IF THE PARENT(S) DOES NOT AGREE WITH YOUR REQUEST OR YOU ARE NOT SURE IF HE/SHE AGREES - Give the parent(s) a stamped copy of your application and the "Notice of Hearing Regarding Application for Change of Name" that shows the date, time, and place of your hearing. Then, have the person sign an "Acceptance of Service". That notarized form serves as the proof of notice. Bring the signed and notarized "Acceptance of Service" to the hearing; OR, Send a copy of your application bearing the Clerk's stamp and the "Notice of Hearing Regarding Application for Change of Name" showing the date, time, and place of hearing by certified mail/restricted delivery (return receipt requested). This must be done at least 30 days before the hearing. Proof of notice for this step is the card returned to you from the Post Office showing delivery. Bring the card and a completed "Affidavit of Service by Certified Mail" to the hearing. The person who should receive notice of the hearing must sign the return receipt. If you do NOT know where the parent(s) lives: A Notice of Hearing that shows the date, time, and place of your hearing must be published once in a newspaper of general circulation in Pinal County at least 14 days before the hearing. This is called notice by publication. If notice is by publication, you must complete a notarized statement explaining in detail what efforts you made to locate the person(s). Bring that statement with you to the hearing. The Court will not accept notification by publication unless diligent efforts have been made to locate the person for whom notification is required.

3.

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version

STEP 6:

ATTEND THE HEARING: WHO: The adult who is requesting a name change for the minor child MUST be present at the hearing. In addition, if the request is for a minor child who is 14 years or older, that child must either be present at the hearing or you may provide a notarized statement from the child consenting to the name change. BRING: These documents are required for your hearing: · 2 copies of "Order Changing Name for a Minor Child" · Photo identification for any person(s) who requests the change of name · A Clerk stamped copy of all filed documents · Proof of Notice as described above in Step 5 · Notarized consent from the other parent or proof that the other parent was served with notice of the Application and the Notice of Hearing. · Prior Name Change orders (If applicable) · Proof of naturalization or resident alien status (If applicable) · Certified copy of child's birth certificate · Order terminating parental rights of the other parent (if applicable) · Adoption Decree (if applicable) · Proof of Guardianship (if applicable) · If the person requesting the change of name, or the child is not a United States citizen, his/her passport or proof of immigration status must also be provided at time of hearing. Always make sure that you make a copy of any documents you submit to the Court and keep those copies for your records. AFTER THE HEARING: If the Judge grants the name change(s), the Order Changing Name will be signed and you will be directed the to Customer Service Counter to receive a conformed copy of the Order. You may need to purchase a certified copy of the Order to complete the change of name with other state and local government agencies. Please check with the Clerk's office for the current fee for purchasing a "Certified Copy" of the Order Changing Name. The fee is payable to the Clerk of the Superior Court by cash, money order, visa or mastercard

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY
In the Matter of:
) ) ) )

CV 2 APPLICATION FOR CHANGE OF NAME FOR A MINOR CHILD [351]

A Minor

STATEMENTS TO THE COURT, UNDER OATH
1. INFORMATION ABOUT ME, THE APPLICANT Name: Address: Date of Birth: Place of Birth: County of Residence: INFORMATION ABOUT THE MINOR CHILD FOR WHOM THIS NAME CHANGE IS REQUESTED: Name: Address: Date of Birth: Place of Birth: County of Residence: Relationship to Applicant: Requested Name: REASON FOR THIS REQUEST FOR CHANGE OF NAME I request that the current name of be changed to

2.

3.

, , for the following reason(s):

4.

ADDITIONAL STATEMENTS A. This application is made solely for the best interest of the minor child named above. It will not release the person from any obligations incurred or harm any rights of property or action in any original name. OATH AND VERIFICATION OF APPLICANT: ) ) ss.

STATE OF ARIZONA COUNTY OF PINAL

I, the Applicant, being duly sworn and under oath, state that I have read this Application. All the statements in the Application are true, correct, and complete to the best of my knowledge and belief. Applicant's Signature SUBSCRIBED AND SWORN TO before me this day of 20 .

By My Commission Expires:
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Deputy Clerk/Notary Public
Change of Name for Minor Use only most current version

In the Superior Court of the State of Arizona In and For the County PINAL Is Interpreter Needed?
Case Number CV Yes No
.

2
If yes, what language:
To the best of my knowledge, all information is true and correct. ___________________________________________________
Attorney / Pro Per Signature (If no attorney, YOUR Signature)

CIVIL COVER SHEET- NEW FILING ONLY
(Please Type or Print) Plaintiff's Attorney __________________________ Attorney Bar Number ________________________ Plaintiff's Name(s): (List all) ______________________________________ ______________________________________

Plaintiff's Address: ________________________________________ ________________________________________

(List additional plaintiffs on page two and/or attach a separate sheet). Defendant's Name(s): (List All) __________________________________ ________________________________________ ________________________________________

(List additional defendants on page two and/or attach a separate sheet)) Temporary Restraining Order Provisional Remedy OSC EMERGENCY ORDER SOUGHT: Election Challenge Employer Sanction Other ______________________________________ (Specify) RULE 8(i) COMPLEX LITIGATION DOES NOT APPLY. (Mark appropriate box under Nature of Action) RULE 8(i) COMPLEX LITIGATION APPLIES. Rule 8(i) of the Rules of Civil Procedure defines a "Complex Case" as civil actions that require continuous judicial management. A typical case involves a large number of witnesses, a substantial amount of documentary evidence, and a large number of separately represented parties. (Mark appropriate box on page two as to complexity, in addition to the Nature of Action case category).

NATURE OF ACTION (Place an "X" next to the one case category that most accurately describes your primary case.)
TORT MOTOR VEHICLE: C01 Non-Death/Personal Injury C02 Property Damage C03 Wrongful Death TORT NON-MOTOR VEHICLE: C13 Negligence C19 Product Liability - Asbestos C19 Product Liability ­ Tobacco C19 Product Liability ­ Toxic/Other C18 Intentional Tort C16 Property Damage C18 Legal Malpractice C18 Premises Liability C18 Slander/Libel/Defamation
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

MEDICAL MALPRACTICE: C21 Physician M.D. C23 Hospital C22 Physician D.O. C24 Other CONTRACTS: C31 Account (Open or Stated) C32 Promissory Note C33 Foreclosure C34 Buyer ­ Plaintiff C34 Fraud C34 Other Contract (i.e. Breach of Contract) C34 Excess Proceeds ­Sale C34 Construction Defect Resident/Commer C34 six to Nineteen Structures C34 Twenty or More Structures
Change of Name for Minor Use only most current version

C18 Other (Specify) OTHER CIVIL CASE TYPES: C82 Eminent Domain / Condemnation C42 Forcible Detainer C43 Change of Name C44 Transcript of Judgment C45 Foreign Judgment C49 Quite Title C52 Forfeiture ­ Vehicle C53 Forfeiture - Cash C54 Forfeiture - Other C56 Election Challenge C58 NCC ­ Employer Sanction Action (ARS §23-212) C64 Injunction against Workplace Harassment C62 Injunction against Harassment C54 Civil Penalty C56 Water Rights (Not General Stream Adjudication) C56 Real Property C56 Sexually Violent Person (ARS §36-3704) C56 Minor Abortion

Special Action Against Lower Courts
C71 JP Civil Traffic C72 Municipal Civil Traffic C73 Civil Non-Traffic C74 Landlord - Tenant

UNCLASSIFIED CIVIL: C55 Administrative Review C60 Tax Appeal- All other tax matters must be filed in the AZ Tax Court) C46 Declaratory Judgment C48 Habeas Corpus C56 Landlord Tenant Dispute - Other C50 Restoration of Civil Rights (Federal) C56 Clearance of Records (ARS §13-4051) C56 Declaration of Factual Innocence C56 Declaration of Factual Improper Party C56 Vulnerable Adult (ARS §46-451) C56 Tribal Judgment C56 Structured Settlement (ARS § 12-2901) C56 Attorney Conservatorships (State Bar) C56 Unauthorized Practice of Law (State Bar) C56 Out-of-State Deposition Foreign Jurisdicti C56 Secure Attendance of Prisoner C56 Assurance of Discontinuance C56 In-State Deposition Foreign Jurisdiction C56 Eminent Domain ­ Light Rail Only C56 Interpleader ­ Automobile Only C56 Delayed Birth Certificate C56 Employment Dispute - Discrimination C56 Employment Dispute -Other C56 Other (Specify)

COMPLEXITY OF THE CASE If you marked the box on page one indicating that Complex Litigation applies, place an "X" in the box of no less than one of the following: Antitrust/Trade Regulation Construction Defect with many parties or structures Mass Tort Securities Litigation with many parties Environmental Toxic Tort with many parties Class Action Claims Insurance Coverage Claims arising from the above-listed case types A Complex Case as defined by Rule 8(i) ARCP Additional Plaintiff(s) ___________________________________________________________________________________ ___________________________________________________________________________________ Additional Defendant(s) ___________________________________________________________________________________ ___________________________________________________________________________________

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY
In the Matter of ) ) ) ) ) CV

2

CONSENT OF PARENT TO NAME CHANGE OF A MINOR CHILD AND WAIVER OF NOTICE

A Minor

REQUIRED INFORMATION FROM PARENT, UNDER OATH:
1. INFORMATION ABOUT ME:
Name: Address: Telephone: Date of Birth: Place of Birth: I am the natural I am the adoptive MOTHER or MOTHER or FATHER of the minor child named above. FATHER of the minor child named above.

2. 3.

I have read the Application for Name Change and consent to changing the child's name to:

I waive notice of all further proceedings in this matter. OATH OF THE PARENT ) )ss.

STATE OF ARIZONA PINAL COUNTY

I have read, understood, and completed the above statements. Everything I have said is true and correct to the best of my knowledge, information and belief. Signature SUBSCRIBED AND SWORN TO before me this day of 20 .

By My Commission Expires:
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Deputy Clerk/Notary Public
Change of Name for Minor Use only most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY
In the Matter of ) ) ) ) ) CV

2

CONSENT OF MINOR TO NAME CHANGE (Only if minor is 14 or older)

A Minor

REQUIRED INFORMATION FROM MINOR, UNDER OATH:
1. INFORMATION ABOUT ME:
Name: Address: Telephone: Date of Birth: Place of Birth: I am the minor who is the subject of this name change request. I am at least 14 years of age.

2.

I have read the Application for Name Change and consent to changing my name to:

3.

I waive notice of all further proceedings in this matter. OATH OF THE MINOR ) )ss.

STATE OF ARIZONA COUNTY OF PINAL

I have read, understood, and completed the above statements. Everything I have said is true and correct to the best of my knowledge, information and belief.

Signature SUBSCRIBED AND SWORN TO before me this day of 20 .

By My Commission Expires:
Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Deputy Clerk/Notary Public
Change of Name for Minor Use only most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY
In the Matter of:
) ) )

CV

2

________________________________)
Name(s) of person(s) who request(s) name change

NOTICE OF HEARING REGARDING APPLICATION FOR CHANGE OF NAME

READ THIS NOTICE CAREFULLY. An important court proceeding that affects your rights has been scheduled. If you do not understand this Notice or the other court papers, contact an attorney for legal advice.

1.

NOTICE IS GIVEN that the Applicant has filed with the Court an Application for Change of Name. At
the hearing, the Court will consider whether to grant or deny the requested name change. If you wish to be heard on this issue, you must appear at the scheduled hearing.

2.

COURT HEARING. A court hearing has been scheduled to consider the Application as outlined below:

DATED:
(Month/Day/Year)

Applicant's Signature

THE COURT COMPLETES THE FOLLOWING SECTION

DATE: LOCATION: BEFORE THE HONORABLE

TIME:

DIVISION

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version

Name of Person Filing Document: Your Mailing Address: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without Attorney) OR Attorney Representing

Petitioner

Respondent

IN THE SUPERIOR COURT OF ARIZONA

PINAL COUNTY
In the Matter of

)
) ) )

CV

2

AFFIDAVIT OF SERVICE BY CERTIFIED MAIL

Name of Applicant

STATE OF ARIZONA COUNTY OF PINAL
1.

) ) ss.

I am familiar with the facts stated in this Affidavit, and I make this Affidavit to show that I have served copies of the "Application for Change of Name" and the "Notice of Hearing Regarding Application for Change of Name" on the person named below by certified mail/restricted delivery, return receipt requested. Person served (name of other party): Address where other party was served: Date of receipt by the other party:

2.

The Application and Notice listed above were received by the other party as shown by the receipt, the original of which is attached to this Affidavit on a separate piece of paper.

Signature

SUBSCRIBED AND SWORN TO before me this

day of

20

.

By My Commission Expires: Deputy Clerk/Notary Public

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version

IN THE SUPERIOR COURT OF ARIZONA PINAL COUNTY

In the Matter of:

) ) )

CV

2

)
) ) A Minor

ORDER CHANGING NAME OF A MINOR CHILD

THE COURT FINDS:
1. 2. 3. 4.
This case has come before this Court to Change the Name of the minor child listed above. This Court has jurisdiction to change the name of the minor child. Good cause exists to grant the application for Change of Name. It is in the best interest of the minor child to change his/her name as set forth below.

IT IS HEREBY ORDERED:
If the child was born in Arizona, the Office of Vital Records shall amend the birth certificate for ______________________________________ whose date of birth is ____________________ and whose place of birth is _______________________________ to reflect the new name of __________________________________________________________.
First Middle Last

This Order does not release the minor child or either parent named above from any obligations incurred or harm any rights of property or action in original name.

DONE IN OPEN COURT this

day of

20

Superior Court Judge/Special Commissioner

Superior Court of Arizona in Pinal County July 8, 2009 ALL RIGHTS RESERVED

Change of Name for Minor Use only most current version