Indiana > Statewide > Family Law (Pro-Se) > Name Change
Order On Verified Petition For Change Of Name - Indiana
| Order On Verified Petition For Change Of Name Form. This is a Indiana form and can be used in Name Change Family Law (Pro-Se) Statewide . |
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STATE OF INDIANA COUNTY OF ) IN THE ) SS: ) CASE NO. CIRCUIT COURT IN RE THE NAME CHANGE OF: ) ) ) ) Petitioner. ) ORDER ON VERIFIED PETITION FOR CHANGE OF NAME On ________________, Petitioner, _______________________________________________, appeared for Change of Name Hearing. Witnesses sworn and evidence presented. Comes now the Court, having reviewed the Verified Petition for Change of Name, Notice of Proof of Publication, and the evidence presented at the hearing, and now finds as follows: 1. 2. That Petitioner's current name is: _________________________________________. That Petitioner's date of birth is: ______________________________. 3. That Petitioner's Indiana driver's license number/ Indiana identification card number was filed with the Court and is preserved in the Court's records. That Petitioner's mailing address is: ________________________________________________ ________________________________________________ And, if different, Petitioner's residence address is: ________________________________________________ _______________________________________________. 4. 5. That Petitioner's has no other previous names or Petitioner's previous names are as follows ___________________________________________________________________________. 6. 7. That Petitioner does/does not hold a valid United States passport. The Petitioner has presented proof of United States citizenship. 8. That the Petitioner has no felony convictions, or, the following judgments of criminal conviction of a felony under the laws of any state or the United States have been entered against the Petitioner: ___________________________________________________________________. 9. I.C. 11-8-8. 10. Page 1 of 2 That Petitioner is not a sex or violent offender who is required to register under That Petitioner has presented proof of publication of notice to the Court. Form PS-34282-4 Approved by State Court Administration 10/10 American LegalNet, Inc. www.FormsWorkFlow.com 11. That pursuant to Indiana Code 34-38-2-1, Petitioner wishes to change his/her name. 12. That Petitioner wishes to change his/her name to be _____________________________________________________. 13. That Petitioner is not seeking to defraud creditors by changing his/her name. WHEREFORE IT IS ORDERED that Petitioner's Petition for Change of Name is GRANTED, and Petitioner's name is hereby legally changed to __________________________________________. SO ORDERED this _______ day of _____________________, 20____. ____________________________________ JUDGE Distribution: Page 2 of 2 Form PS-34282-4 Approved by State Court Administration 02/10 American LegalNet, Inc. www.FormsWorkFlow.com
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