Petition For Change Of Minors Name (One Parent Petitioning) {3490}

REV 4/1/19 JCB 1 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( city ) ( state ) ( When the minor moved to Washoe County ) ( Minor222s current legal name you wish to change ) Code: 3490 Name: Address: Telephone: Email: Self-Represented Litigant IN THE FAMILY DIVISION OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN AND FOR THE COUNTY OF WASHOE In the Matter of the Change of Name of: . Case No. Dept. No. A Minor. / PETITION FOR MINOR NAME CHANGE I petition this Court as follows: I am the parent of the above-named minor child.I consent to the child222s name change.I am not seeking a name change for any illegal or fraudulent purpose.The child is resident of Washoe County.The child has been a resident since . 5.The child was born on // in , . American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 2 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 6. (a) The addresses, person(s) with whom the child lived with, and their relationship to the child is as follows for the last five years: Date Child Moved Here Address Person(s) With Whom Child Lived The Person(s) Relationship to Child / / / / / / / / (b) Please identify any other court case in which you have participated as a party, witness, or in any other way concerning the custody of or visitation with the child. If there are no other court cases, please check this box . Court: Case number: Date of custody determination: (c) Please identify any court case that could affect this case, including any case relating to domestic violence, protective orders, termination of parental rights, adoptions, guardianships, dependency, and paternity actions. If there are no other court cases, please check this box . Court: Type of case: Case number: Date of last order: (d) Please identify the name(s) and address(es) of any person(s) not a party to this court case who claim(s) a right to legal custody, physical custody or visitation with the child. If this is not applicable, please check this box . Name(s) and address(es) of person(s) claiming custody or visitation rights: American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 3 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( first) ( middle ) ( last ) ( last ) ( middle ) (first) ( Amount of time child has used legal name ) 7. The child IS 226OR226 IS NOT 14 years of age or older. If they are, a separate consent HAS 226OR226 HAS NOT been filled out by the child. 8. My current address is: My mailing address is ( Check one): SAME AS ABOVE 226OR226 OTHER: The current address of the Other Parent is: The mailing address of the Other Parent is ( Check one): SAME AS ABOVE 226OR226 OTHER: 9. I wish to change the child222s name from: to: 10. The child has used their current name for 11. The Other Parent does not consent to the name change because: The parent is deceased. The parent222s rights were terminated on //. A copy of the order is attached. Other: If more room is needed, attach additional sheets. American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 4 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( Amount of time child has used current legal name ) ( Name child goes by, if different than current legal name ) 12. We originally agreed on the minor222s current name. 226OR226 The minor222s current name was chosen without the consent of both parents. 13. The child has used their current name for 14. The child goes by their current name. 226OR226 The child goes by 15. The child222s name should be changed because: If more room is needed, attach additional sheets. Explain, in detail, 1) why you want to change the child222s name, and 2) why the name change is in the best interests of the child. American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 5 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 16. Changing the child222s name WILL 226OR226 WILL NOT cause insecurity or identity confusion. If it will, explain: 17. The name change WILL 226OR226 WILL NOT change the child222s name to be the same as other family members. If it will, please identify the family members: 18. The name change IS 226OR226 IS NOT being requested for cultural reasons. If it is, explain: 19. The child WILL 226OR226 WILL NOT suffer any embarrassment, discomfort, or inconvenience by the name change. If they will, explain: // // // // American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 6 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 20. My relationship with the child will be impacted by the name change in the following way(s): 21. The Other Parent222s relationship with the child will be impacted by the name change in the following way(s): 22. The child HAS 226OR226 HAS NOT been convicted of a felony. If the child has been convicted of a felony, state the date of conviction, the County and State of conviction, the offenses, and the final sentence: If more room is needed, attach additional sheets. This document does not contain the personal information of any person as defined by NRS 603A.040. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. Date: Signature: Print Your Name: American LegalNet, Inc. www.FormsWorkFlow.com REV 4/1/19 JCB 7 NM-2 PETITION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 VERIFICATION I, (your name) , declare that I am the Petitioner in the above-entitled action; that I have read the foregoing Petition and know the contents thereof; that the pleading is true of my own knowledge, except for those matters therein contained stated upon information and belief, and that to those matters, I believe them to be true. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. SIGNATURE American LegalNet, Inc. www.FormsWorkFlow.com