Hawaii Name Change Forms – How to Change Your Name in HIHawaii Name Change Forms – How to Change Your Name in HIHawaii Name Change Forms – How to Change Your Name in HI
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IN THE OFFICE OF THE LIEUTENANT GOVERNOR
OF THE STATE OF HAWAII
In the Matter of the Petition

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of
(1)
For Change of Name

PETITION
TO THE HONORABLE SHAN S. TSUTSUI, LIEUTENANT GOVERNOR OF THE
STATE OF HAWAII:
(2)

COMES NOW
your petitioner herein, and respectfully pray that an order be entered herein

(3)

changing

name and in support thereof represents as follows:
I.

(4)

That your Petitioner’s date of birth is
place of birth is
father’s name is
(Name as shown on birth certificate)
mother’s maiden name is
(First)
(Middle)

(Surname)

II.
(5)

That the name on your Petitioner’s birth certificate or certificate of naturalization is
(First)

(Middle)

(Surname)

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III.
(6)

That other names Petitioner is using or has used are as follows:

IV.
(7)

That your Petitioner is a resident of the State of
and Petitioner’s present address is
(Residence address)

V.
(8)

That your Petitioner:
has not been convicted of a felony or a sexual offense.
has been convicted