Louisiana Name Change Forms – How  to Change Your Name in LALouisiana Name Change Forms – How  to Change Your Name in LA
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___ JUDICIAL DISTRICT COURT
______________ PARISH
STATE OF LOUISIANA
Case No.

Division

PETITIONER
vs.
_______________________, DISTRICT ATTORNEY
DEPUTY CLERK:

FILED:

*******************************************************************

SELF-REPRESENTED LITIGANT
PETITION FOR NAME CHANGE
I. PETITIONER
Petitioner,

, born on

, with,

social security number

and domiciled in ____________ Parish,

Louisiana, wants to change his/her name to
for the following reason(s):
II. REASON[S] FOR NAME CHANGE

III. LAW GOVERNING NAME CHANGE
This proceeding is brought under LSA—R.S. 13:14751-13:4755, and it is thus mandatory
that the district attorney of this parish be served with a copy of this petition and be cited
to answer it.
IV. PRAYER
WHEREFORE, petitioner prays for judgment changing his/her name from
to

RESPECTFULLY SUBMITTED,

Petitioner’s Name
Address

Telephone
Forms prepared by the Louisiana State Bar Association Access to Justice Department and the Judicial
District Court. No represent