Free Petition for Change of Name - New Hampshire

Instructions

Clear Form

THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

Name change of

PETITION FOR CHANGE OF NAME FOR ADULT MINOR
1. Petitioner Name Mailing Address 2. Minor Name Mailing Address Relationship of petitioner to minor 3. Attorney Name Mailing Address Telephone Bar ID# Telephone Telephone

PLEASE COMPLETE THE FOLLOWING INFORMATION AS IT APPLIES TO THE PERSON WHOSE NAME IS BEING CHANGED. 4. 5. 6. Town of residence Date of birth If minor, name of mother Mailing Address 7. If minor, name of father Mailing Address 8. Check the following paragraphs that apply to the person whose name is being changed. I am a person who is serving a prison sentence, or who is on probation or parole. I certify that I have had the sheriff's department serve a copy of this petition on the department of corrections. I understand that failure to comply with notification requirements shall cause any order hereunder to be null and void. I am a person who is required to register as a sexual offender or an offender against children pursuant to RSA 651-B. I certify that I have had the sheriff's department serve a copy of this petition on the department of safety or other agency. I understand that failure to comply with notification requirements shall cause any order hereunder to be null and void. Neither of the above paragraphs are applicable to this name change.
NHJB-2175-P (06/04/2008) (formerly AOC-087-003) Page 1 of 2

Place of birth

Case Name: Name change of Case Number: PETITION FOR CHANGE OF NAME

The petitioner requests that the name
(First, middle and last names)

be changed in accordance with the laws of the State of

to
(First, middle and last names)

New Hampshire and for the following reasons:

Except as noted in #8, I certify that I have provided a copy of this document to the parties who have filed an appearance in this case or are otherwise interested parties.

Date

Petitioner Signature

PLEASE NOTE: If change is for a minor, a certified copy of birth certificate must accompany this petition. If change is for an adult, proof of identity must accompany this petition.

ORDER The above petitioner has sworn before the judge that the facts are true to his/her best knowledge and belief. Accordingly, the court orders that: Petition is granted.

Petition is denied.

Date

Judge

NHJB-2175-P (06/04/2008) (formerly AOC-087-003)

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