Request To Change Name
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1PS–12
Case Number:
(the clerk fills this in)
Request to Change Name
(For An Adult)
8/08
In the Probate Court of (county):__________________________________________ County, Alabama
Your current name:
first
middle
last
To ask the court to change your name, you must fill out this form, and:
Attach a certified copy of your birth certificate and a copy of your photo ID, and
•
File your form and attachments in the same county where you live.
•
I declare that the following information is true:
q
My current name is:
first
middle
last
w
My address is:
street
city
state
zip
e
My phone numbers are
(home):
(work):
r
My date of birth is
(mm/dd/yyyy):
t
My name at birth was:
first
middle
last
y
I am an adult (19 or older), of sound mind, and live in
(name of Alabama county):
u
The attached copy of my photo ID is my
Driver’s license, #
(check one):
Non-driver’s photo, ID #:
i
I ask the court to change my name because
(explain why you want to change your name):
o
I want my new name to be:
first
middle
last
a
I also declare:
I am not now facing criminal charges, nor am I involved in any other court case.
•
I have never been convicted of a criminal sex offense (as defined in Alabama Code § 15-20-21),
•
a crime of moral turpitude, or a felony.
I am not asking to change my name to avoid paying my debts or to commit fraud.
•
I swear that all of the information I have provided above is complete and accurate.
•
I ask the court to grant this request and to issue an order changing my name.
Sign below in front of a notary:
Date:
Notary fills out below—
Sworn to and subscribed before me, the undersigned authority,
By (Print name of notary):
On this date:
(Notary’s seal here)
/
/
Notary signs here
Date notary’s commission expires
Rev. 8/08
2008 Alabama State Bar
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Parent category: Legal