Kentucky Name Change Forms – How to Change Your Name in KY
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AOC-295
Doc. Code: PNC
Rev. 10-08
Page 1 of 1
Commonwealth of Kentucky
Court of Justice
www.courts.ky.gov
KRS Chapter 401

Case No.
Court

PETITION FOR NAME CHANGE

County

IN RE: CHANGE OF NAME FOR _____________________________________________________________________
COME(S) THE PETITIONER(S), (choose one):
__________________________________________ and _____________________________________________,
living parents of the above-captioned minor (minor refers to child under age 18, see KRS 401.020); or
____________________________________________________, surviving parent of above-captioned minor; or
_________________________________________________________, guardian of above-captioned minor; or
above-captioned adult, AND IN SUPPORT OF THIS PETITION STATE(S):
1. The original name is

.

2. The desired name change is

.

3. Birthdate (MM/DD/YY) of minor/adult is

.

4. Birth location (city, county, state) of minor/adult is:

,

,

.

5. Minor/Adult currently resides in the county