Pennsylvania Name Change Forms – How to Change Your Name in PAPennsylvania Name Change Forms – How to Change Your Name in PAPennsylvania Name Change Forms – How to Change Your Name in PA
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IN THE COURT OF COMMON PLEAS OF ____________ COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN RE: CHANGE OF NAME OF
(1) _______________________
a minor, by (2) __________________

:
:
:
:

No.

PETITION FOR CHANGE OF NAME
TO THE HONORABLE, THE JUDGES OF SAID COURT:
The Petition of (1) ____________________ , by [if a minor] (2) ___________________,
respectfully represents:
1.

The Petitioner is (1) ______________________dob:

(3)

______________, wishes

to have his/her name changed because (4)___________________________________
_________________________.
IF A MINOR, USE THE PARAGRAPH 1. BELOW.
1.

The Petitioner is (2) __________________________, wishes to change the name

of his/her minor child (1) ____________________________, dob:

(3)

_________________,

because (4) _________________________________________________________________
_________________________.
2.

Petitioner has resided at (5) _____________________________________

_________________, during the five (5) years preceding the