Free Petition for Name Change - Kentucky

AOC-295 Doc.Code:PNC Rev.10-08 Page1of1 CommonwealthofKentucky CourtofJustice www.courts.ky.gov KRSChapter401

CaseNo. Court





PETITION FOR NAME CHANGE

County

IN RE: CHANGE OF NAME FOR _____________________________________________________________________ COME(S) THE PETITIONER(S),(choose one):




__________________________________________and _____________________________________________, livingparentsoftheabove-captionedminor(minorreferstochildunderage18,seeKRS401.020); or ____________________________________________________,survivingparentofabove-captionedminor;or _________________________________________________________,guardianofabove-captionedminor;or above-captionedadult,AND IN SUPPORT OF THIS PETITION STATE(S): , . . . .

1. Theoriginalnameis

2. Thedesirednamechangeis

3. Birthdate(MM/DD/YY)ofminor/adultis

4. Birthlocation(city,county,state)ofminor/adultis:

,Nicholas

5. Minor/AdultcurrentlyresidesinthecountyinwhichthisPetitionisfiled.His/Heraddressis:

6. Purposeofdesirednamechangeis: .IunderstandidentitytheftisaClassDFelony inKentucky.KRS514.160.I am not requesting this name change to avoid a legal obligation or evade prosecution. 7. For petition of minor with two living parents:PerKRS401.020,ifaparentrefusesorisunavailabletoexecutethis Petition,proper noticeofitsfilingshall be made on absent parentpursuanttotheRulesofCivilProcedure.





Father: Address: Mother: Address:

































WHEREFORE,Petitioner(s)pray(s)foranOrderforChangeofName. Dated: Petitioner's Signature Attorney Name: HEARING Schedulehearingfor at Judge a.m. ,2 p.m.
Subscribedandsworntobeforemeon ,2 . ,2 .

,2

. Petitioner's Signature

Mycommissionexpires: Notary

Note:FilethisPetitionintheCircuitClerk'sOfficeinthecountyinwhereyoureside. Distribution for Hearing Notice:Petitioner(s)ORAttorneyforPetitioner(s),ifany

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