Petition For Dissolution Of Marriage (With Children) Form Page 16
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173. The child(ren)’s PFD funds:
May be spent for the child(ren)’s health, education, and welfare.
May be spent only if both parents provide prior written approval.
Other:
IX.
RESTORE OR CHANGE NAME
Restore Name. Petitioner wants a prior name restored as follows (print full names clearly):
From:
To:
(Party A’s current full name)
(Party A’s prior full name)
From:
To:
(Party B’s current full name)
(Party B’s prior full name)
Change to New Name. [Before checking this box, it is important to read pages 16-17 of the
instructions. Failure to publish notice of your hearing on the court’s website may delay the
decree of dissolution or result in denial of the requested name change.]
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.
X.
OTHER AGREEMENTS (IF ANY)
Signature of Party A
Signature of Party B
Page 16 of 17
DR-105 (8/15)(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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