Instructions For Change Of Name (Adults Only) (Page 2 of 3) in pdf

STATE OF ALABAMA

PROBATE COURT

MADISON COUNTY

CASE NO. __________

PETITION FOR CHANGE OF NAME

TO THE HONORABLE TOMMY RAGLAND, JUDGE OF PROBATE:

NOW COMES, _____________________________________________________, whose date of birth is

_________________________ whose Driver’s License/Non-Driver’s License ID number is ____________________

from the State of ___________________ and respectfully shows to the Court that he/she is over the age of nineteen

years and is a bona fide resident of Madison County, State of Alabama;

WHEREFORE, in pursuance of the provisions of the Statutes of Alabama, the petitioner files this declaration in

writing, signed by him/her, requesting his/her name be changed as follows: (Choose one)

1) (Legal Name on Birth Certificate) FROM ______________________________________________ TO

______________________________________________________,

due

the

following

reason:

______________________________________________________________________________;

OR:

2) (Married Name) FROM ____________________________________________________________ TO

___________________________________________________________, due to the following reason:

_____________________________________________________________________________;

OR:

3) (Other Reason) FROM ________________________________________________________________

___________________________________________________________, due to the following reason:

_______________________________________________________________________________.

Your petitioner further states:

That a true and correct copy of my birth certificate has been filed along with this petition;

That he/she has never been convicted as a Criminal Sex Offender, as provided by Act 98-489;

That he/she is not currently a party to any judicial proceeding in any court in any jurisdiction;

That he/she is not currently a defendant to any criminal charge;

That he/she is not attempting to avoid payment of any debt or judgment of debt;

That he/she is not attempting to commit fraud in any manner whatsoever;

That he/she has never been convicted of any felony or crime involving moral turpitude;

That he/she is subject to a criminal background check;

Your petitioner prays that the Court will make such order in the premises as may be proper to change his/her

name as prayed.

I, the undersigned authority, a Notary Public, in and for said County in said State, hereby certify that said

petitioner, whose name is signed to the foregoing instrument, and who is known to me, acknowledged before me on this

day, that being informed of the contents of said petition, that he/she executed the same voluntarily on the day the same

bears date.

DATED:_____________________

_______________________________________

PETITIONER

ADDRESS: _____________________________

_______________________________________

______________________________

Home Phone No. (256) _____________________

NOTARY PUBLIC

Work Phone No. (256) _____________________

Instructions For Change Of Name (Adults Only) Page 2

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