eForm: Petition for Change of Name (Adult—no dissolution of marriage)
*Caution: this form requires protected information and the filing of a separate Protected Information Form.
In the Iowa District Court for ________________ County
Petition for Change of Name
(Adult—no dissolution of marriage)
In re the Name Change of:
If you need assistance to participate in court due to a disability,
contact the disability coordinator (information at
Persons who are hearing or speech impaired may call Relay
Iowa TTY (1-800-735-2942). Disability coordinators cannot
provide legal advice.
Petitioner, for this Petition for Change of Name under Iowa Code chapter 674, states:
1. Petitioner’s present full name is _______________________________________________,
and petitioner resides in ________________________________ County, Iowa.
2. Petitioner is ____ feet, ____ inches tall; weighs______ lbs.; has _____