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Request For Name Change - Georgia

Request For Name Change Form. This is a Georgia form and can be used in Miscellaneous State Bar Of Georgia Statewide .
 Fillable pdf Last Modified 5/19/2005
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STATE BAR OF GEORGIA MEMBERSHIP 104 MARIETTA STREET SUITE 100 ATLANTA GA 30303 REQUEST FOR NAME CHANGE -- FAX FORMS TO (404) 527-8747 Please be advised that the following attorney has changed their name. Bar Number____________________ Current name on Bar Membership Records____________________________________ Please change the current name on Bar Memb ershipRecords to reflect the new name below (copy of legal document that changed name must be provided). New Name___________________________________________ Address______________________________________________ City____________________ State__________ Zip_________ Office Telephone Number______________________ Home Telephone Number_______________________ Email_______________________________________ Check below if this also reflects a change of address. ____The above also reflects a change of address. Please make the above referenced change in my records. If you have any further questions regarding this matter please call me at ______________________. _____________________________________________ (Sign name here) (Date) Questions: Call (404) 527-8777 or email
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