Petition For Name Change - Arkansas Circuit Court (Page 2 of 2) in pdf

Petition For Name Change - Arkansas Circuit Court Page 2

July 2006

Family Law Series

Petition For Name Change

IN THE CIRCUIT COURT OF ____1______ COUNTY, ARKANSAS

_________1_______DIVISION

IN RE: ______2________

PETITION FOR CHANGE OF NAME

The petitioner, ______3_____, hereby states:

Petitioner is over the age of eighteen (18) years and is a resident of ______4________ County, Arkansas.

Petitioner wishes to change his/her last name because ______5_______.

Therefore, she/he would like to be known henceforth as ____________6__________.

WHEREFORE, petitioner requests that an order be entered changing his/her name from

_____7____ to

______7____.

Respectfully submitted

_______8___________

Petitioner

ORDER FOR NAME CHANGE

On this date, the petition of ______________________________ is presented, the petitioner appearing in

person, pro se, and the Court, from the petition filed herein, the testimony given, and other proof before the Court,

finds:

The petitioner has shown reasonable cause for changing his/her name.

IT IS THEREFORE ORDERED that petitioner’s name be changed from ____________________ to

_______________________________ and that petitioner shall hereinafter be known

as_________________________________, and IT IS FURTHER ORDERED that he/she shall sue and be sued, plead

and be impleaded, by the name_________________________________________________.

IT IS FURTHER ORDERED that the petition filed here in and this order be entered by the Clerk upon the

record of this Court.

___________________________________

CIRCUIT JUDGE

___________________________________

Date

PREPARED BY:

______________________________

A Collaboration of

Center for Arkansas Legal Services, Legal Aid of Arkansas & Arkansas Volunteer Lawyers for the Elderly

1-800-9 LAW AID or

Petition For Name Change - Arkansas Circuit Court Page 2