Your Name: ________________________
City, State, Zip: _____________________
DISTRICT COURT ______________________ COUNTY, NEVADA
In the Matter of the Application of:
CASE NO.: ____________________
(print the old name you do not want anymore)
For Change of Name.
PETITION FOR ADULT NAME CHANGE
Petitioner respectfully states as follows:
1. Petitioner was born on (date of birth) ___________________________________ in
(city) ____________________, (state) ___________________________.
2. Petitioner has resided in ____________________ County, Nevada since (date)
____________________ and intends to live in ____________________ County, Nevada
3. Petitioner’s current legal name is: (clearly print the old name you do not want anymore)