Petition For Dissolution Of Marriage Page 14
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15VIII. RESTORATION OR CHANGE OF NAME.
Restoration. Petitioner wants a prior name restored as follows: (Print full names clearly.)
From:
To:
(wife’s current full name)
(wife’s prior full name)
From:
To:
(husband’s current full name)
(husband’s prior full name)
Change. [Before checking this box, it is important to read pages 15-17 of the instructions
about publication costs and hearing delay.]
Petitioner
wants to take and be legally
(current legal name)
known by a new name, which is
The reasons for this request for a change of name are:
Petitioner seeks this name change for personal reasons and not to avoid judgments, debts,
obligations, or to defraud any person. The reasons stated are consistent with the public
interest.
IX. OTHER AGREEMENTS.
Husband’s Signature
Wife’s Signature
Page 14 of 15
DR-105 (4/09)(cs)
AS 25.24.200-.260
PETITION FOR DISSOLUTION OF MARRIAGE (WITH CHILDREN)
Civil Rule 90.1(a), f(2)(A)(B), (i)(1)
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