Petition For Change Of Name - Tennessee Chancery Court
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2IN THE CHANCERY COURT FOR DAVIDSON COUNTY, TENNESSEE
PETITION FOR CHANGE OF NAME
IN RE:
____________________________________
Docket No. _________________
Petitioner (Print or Type)
Comes now the petitioner requesting change of name and makes oath and/or affirmation that the following facts are correct and
complete:
1. My full name is _____________________________________________________________. I am
(Current Legal Name)
a resident of ____________________________________ County, Tennessee, residing at:
______________________________________________________________. I am a citizen of __________________________.
2. I am more than 18 years of age. I was born on ____________________________________ in
___________________________, in ____________________________ County. The name given to me at birth was
(City)
__________________________________________________________ as reflected on my birth certificate issued by the State of
_________________________________________.
3. All other names and aliases by which I have been identified since birth are (state in chronological
order): _________________________________________________________________________________________________,
_______________________________________________________________________________________________________.
4.
I desire to change my name from ________________________________ to _______________________________.
5. The reasons for the name change are:
_______________________________________________________________________________________________________.
6. The change of my name will not adversely affect the rights of any minor children nor require that their names be changed.
I am not seeking this change of name to evade the claims of my creditors, to evade legal process, nor for any other unlawful purpose.
7. a) Have you been convicted of a felony?
Yes
G No
If you answer “Yes” to question 7a, complete question 7b.
b) I have been convicted of the felony of ________________________________________________.
8. In support of this Petition, I attach copies of my birth certificate, photo identification (such as a driver=s license, passport or
comparable photo identification), and social security card.
I swear or affirm that I have read the Petition and the facts are correct and complete.
Petitioner _________________________________________
Sworn to and subscribed before me this _____ day of ________________, 20___.
Cristi Scott, Clerk and Master
___________________________________D.C.
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