Final Consent Order To Amend Minor Child'S Birth Certificate And For Name Change Of Minor Child Form - Superior Court Of Cobb County Page 2
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2(Input Father’s name as it appears on the Birth Certificate) shall be removed as the person shown on the minor child’s Birth
Certificate as the Father, and it is ORDERED that the name of the child’s natural Father, _____________________________, (Input
full name of Father as you want it to appear on the Birth Certificate) be added to the child’s Birth Certificate, as it has been shown,
and the Court ORDERS, that said minor child is the legitimate child of _____________________________ (Input name of natural
Father), the person so named.
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Petitioner and Respondent further request that the minor child’s name be amended on his/her Birth Certificate, and that the
Birth Certificate shall state that the minor child’s name is _____________________________ (Enter full and complete name that
minor child is to be known by).
IT IS SO ORDERED, this _________________ day of __________________________, 20_________.
__________________________________________________
Judge, Superior Court
Cobb Judicial Circuit
CONSTENTED TO BY:
_________________________________________________________
(Sign your name here before Notary)
Petitioner, Pro se
Petitioner’s name (print or type): _______________________________
Petitioner’s Address: ________________________________________
________________________________________
Petitioner’s Telephone Number: _______________________________
Sworn to and affirmed before me, this
_______ day of _________________.
______________________________
NOTARY PUBLIC
My commission expires: __________
(Notary Seal)
__________________________________________________________
(Sign your name here before Notary)
Respondent, Pro se
Petitioner’s name (print or type): ______________________________
Petitioner’s Address: ________________________________________
________________________________________
Petitioner’s Telephone Number: _______________________________
Sworn to and affirmed before me, this
_______ day of _________________.
______________________________
NOTARY PUBLIC
My commission expires: __________
(Notary Seal)
________________________________________________________________________________________________________________
“Final Consent Order to Amend Minor Child’s Birth Certificate and For Name Change of Minor Child”
Page 2 of 2
Provided by the Superior Court.of Cobb County.
rev 1. 05/2008
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