Order Changing Name Of Minor
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SUPERIOR COURT OF ARIZONA
IN MOHAVE COUNTY
In the Matter of:
______________________________
Case Number: ______________________________
A Minor
ORDER CHANGING NAME OF MINOR
THE COURT FINDS:
1.
This case has come before this Court to change the legal name of the minor named above.
2.
This Court has jurisdiction to change the legal name of the minor.
3.
Good cause exists to grant the application for change of legal name.
4.
It is in the best interest of the minor to change the legal name as set forth below.
THE COURT ORDERS:
1.
That the legal name of the minor born this date: ______________ ___________ ___________
(
Month)
(Day)
(Year)
Place of Birth: _____________________ ____________________ ______________________
(City)
(State)
(Nation)
Whose mother is: __________________ ____________________ ______________________
(First)
(Middle)
(Last)
IS CHANGED FROM: Name on Birth Certificate
_________________________ _________________________ _________________________
(First)
(Middle)
(Last)
TO: New Name
_________________________ _________________________ _________________________
(First)
(Middle)
(Last)
2.
For a person born in the State of Arizona, the Office of Vital Records is ordered to amend the
birth record to reflect the new name as ordered above.
For a person born in a state other than Arizona, to the extent that the agency that maintains
birth records in that state is authorized to honor an order of this Court, that agency is requested or
ordered to amend its birth records to reflect the new name as ordered above.
3.
This Order does not establish paternity or add the name of a father to a birth certificate.
Page 1 of 2
Revised: 12/31/2009
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