STATE OF SOUTH CAROLINA
COUNTY OF _______________
In Re: ______________________
IN THE FAMILY COURT OF THE
___________ JUDICIAL DISTRICT
PETITION FOR NAME CHANGE
The Petitioner would respectfully show unto the Court:
Petitioner is a resident of _________________ County, South Carolina.
Petitioner is ______ years of age.
Petitioner was born in _____________________, on _________________________.
The name on Petitioner’s birth certificate is ___________________________; a copy of
Petitioner’s birth certificate is attached hereto.
Petitioner wishes to change his/her name __________________________________.
Petitioner wishes to change his/her name to _________________________________.
Petitioner has attached hereto the results of a criminal background check and a
statement from SLED indicating that she/he is not listed on the division’s sex offender registry.
Petitioner has attached hereto a screeni