Arizona Name Change Forms – How to Change Your Name in AZArizona Name Change Forms – How to Change Your Name in AZArizona Name Change Forms – How to Change Your Name in AZ
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Name of Person Filing:
Street Address:
City, State, Zip Code:
Telephone Number:
Representing Self (No Attorney), or
If Attorney, Bar Number:

Represented by Attorney
For Clerk’s Use Only

SUPERIOR COURT OF ARIZONA
IN _____________________ COUNTY
In the Matter of

Case Number: CV

APPLICATION FOR CHANGE OF
NAME FOR AN ADULT
Current Name of Applicant

(A.R.S. § 12-601)

INFORMATION ABOUT ME, THE APPLICANT
1.

BIRTH NAME: on your original registered state Birth Record (Certificate):
First

Middle

Last

Date of Birth:
City of Birth:
County of Birth:

2.

CURRENT LEGAL NAME:
First

Middle

Last

Current Address: _________________________________________________________
Current City of Residence: __________________________________________________
Current State of Residence & Zip Code: _______________________________________

 This is my married name, and that of my  Current Spouse  Past Spouse
3.

OTHER NAMES: (Check all that Apply)

I was previously married –
From ______________ to _